Facial Plast Surg 2017; 33(03): 329-333
DOI: 10.1055/s-0037-1602144
Rapid Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

V-Y Advancement Flap for Defects of the Lid–Cheek Junction

Nicola A. Quatrano
1   Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
,
Mary L. Stevenson
1   Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
,
Anthony P. Sclafani
2   Division of Facial Plastic Surgery, Department of Otolaryngology, Weill Cornell Medical College, New York, New York
3   Center for Facial Plastic Surgery, New York, New York
,
John Carucci
1   Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2017 (online)

Abstract

We report a series of 10 patients who underwent inferolaterally based V-Y advancement flaps for reconstruction of defects involving the lower eyelid and infraorbital cheek junction. Defects ranged from 1.7 to 2.9 cm in largest diameter, and patients ranged from 59 to 84 years of age. All patients had excellent functional and cosmetic outcomes without subsequent surgical or laser revision. There were no instances of flap necrosis, hematoma, or ectropion. Vertically oriented V-Y flaps are often underused in this setting largely due to the perceived increase risk of ectropion. We describe a modification of the flap with lateral orientation that both diminishes the downward tension vector, which threatens ectropion, and conceals incision scars within resting tension lines, providing superior functional and aesthetic outcomes. Our series demonstrates that a properly designed and well-executed inferiorly based V-Y advancement flap can be used as a safe reconstructive modality for defects involving the lid–cheek junction.

 
  • References

  • 1 Finley EM, Katz JL. Mohs micrographic surgery. In: Ratz JL, Geronemus RG, Goldman MP. , eds. Textbook of Dermatologic Surgery. Philadelphia, PA: Lippincott Williams & Wilkins; 1998: 417-438
  • 2 Shriner DL, McCoy DK, Goldberg DJ, Wagner Jr RF. Mohs micrographic surgery. J Am Acad Dermatol 1998; 39 (01) 79-97
  • 3 Nema HV, Nema N. Diagnostic Procedures in Ophthalmology. 3rd ed. New Delhi, India: JP Medical; 2014: 367-368
  • 4 Rubin P, Mykula R, Griffiths RW. Ectropion following excision of lower eyelid tumours and full thickness skin graft repair. Br J Plast Surg 2005; 58 (03) 353-360
  • 5 Mustardé JC. The use of flaps in the orbital region. Plast Reconstr Surg 1970; 45 (02) 146-150
  • 6 Honda K, Reichel J, Odland P. Anchored rotation flap for infraorbital cheek reconstruction: a case series. Dermatol Surg 2007; 33 (04) 516-520
  • 7 Goldman GD. Rotation flaps. Dermatol Surg 2005; 31 (8 Pt 2): 1006-1013
  • 8 Harris GJ, Perez N. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion. Ophthal Plast Reconstr Surg 2003; 19 (01) 5-13
  • 9 Lewin JM, Sclafani AP, Carucci JA. An inferiorly based rotation flap for defects involving the lower eyelid and medial cheek. Facial Plast Surg 2015; 31 (04) 411-416
  • 10 Chandawarkar RY, Cervino AL. Subunits of the cheek: an algorithm for the reconstruction of partial-thickness defects. Br J Plast Surg 2003; 56 (02) 135-139
  • 11 Sugg KB, Cederna PS, Brown DL. The V-Y advancement flap is equivalent to the Mustardé flap for ectropion prevention in the reconstruction of moderate-size lid-cheek junction defects. Plast Reconstr Surg 2013; 131 (01) 28e-36e
  • 12 Trevaskis AE, Rempel J, Okunski W, Rea M. Sliding subcutaneous-pedicle flaps to close a circular defect. Plast Reconstr Surg 1970; 46 (02) 155-157
  • 13 Zook EG, Van Beek AL, Russell RC, Moore JB. V-Y advancement flap for facial defects. Plast Reconstr Surg 1980; 65 (06) 786-797
  • 14 Doermann A, Hauter D, Zook EG, Russell RC. V-Y advancement flaps for tumor excision defects of the eyelids. Ann Plast Surg 1989; 22 (05) 429-435
  • 15 Marchac D, de Lange A, Bine-bine H. A horizontal V-Y advancement lower eyelid flap. Plast Reconstr Surg 2009; 124 (04) 1133-1141
  • 16 Li JH, Xing X, Liu HY, Li P, Xu J. Subcutaneous island pedicle flap: variations and versatility for facial reconstruction. Ann Plast Surg 2006; 57 (03) 255-259
  • 17 Omidi M, Granick MS. The versatile V-Y flap for facial reconstruction. Dermatol Surg 2004; 30 (03) 415-420
  • 18 Bain III EE, Carucci J. Repair of adjacent ocular defects. Dermatol Surg 2015; 41 (06) 741-743