Transposition movement of V–Y flaps for facial reconstruction

Abstract

The V-Y advancement flap has been widely used for the reconstruction of cutaneous defects for decades; however, the movement of a V-Y flap is sometimes limited, allowing only for rotation or advancement movement. To overcome this limitation, the present study introduces a transposition movement of the V-Y flap and assesses its clinical outcome for facial reconstruction. A modified V-Y flap was designed with a single laterally based pedicle and transferred to the defect through a transposition movement. The transposition movement was demonstrated with photographs and the clinical outcome was described in six patients. This modified V-Y flap was reliable and robust, and could be moved easily with less tension. Meanwhile, the flap allowed for a primary closure of the defects along the nasolabial fold or preauricular crease. More importantly, all six patients achieved satisfactory functional and cosmetic outcomes in facial reconstruction. Temporary sensory alteration was common in the flap skin during the initial postoperative period, but improved as time passed and disappeared about 6 months later. This modified transposition V-Y flap may serve as an alternative option for aesthetic reconstruction of facial defects.