Sinus surgery was first introduced by the ancient Egyptians. In 1750 was the first modern description of frontal sinus surgery. In 1898, Riedel advocated complete removal of the anterior table and floor of the frontal sinus while simultaneously stripping the mucosa. The major postoperative issue involved gross forehead deformity. We aim to provide a modification to reduce the postoperative "step" defect. Riedel's procedure is an effective way of managing frontal sinus disease when endoscopic surgery has repetitively failed. Use of a pedicled pericranial/galeal soft tissue flap can effectively reduce cosmetic deformity postoperatively.