Amplified V-Y flaps for nasal defects

Abstract

Due to a paucity of subcutaneous tissue in the nose, mobilization of some flaps is impeded and large nasal defects are thus difficult to close with traditional V-Y flaps. The V-Y flap is modified by the addition of an amplified limb onto the advancing edge of the V-Y flap. This limb is located adjacent to the area requiring reconstruction and is hinged down on the end of the V-Y flap to close the distal portion of the defect. The amplified V-Y flap, a modified V-Y advancement flap, is very useful for the closure of relatively large defects on the nasal area. We have used this flap for nasal defects as large as 2.5 cm in diameter following excision of skin tumors on the nose in 11 patients. Most excised tumors were basal cell carcinomas. The results have been quite good, with only minor complications in two patients. Complications were encountered only in the nasal tip region, there was partial necrosis at the tip of the amplified portion of the flap. The modifications of the V-Y flap described has extended the application in closing nasal defects.

Assessment of Amplified v-Y Flaps for Nasal Defect Reconstruction

“…Defects up to 3.2cm were closed successfully by using amplified V-Y advancement flap (table I). In 1998 Park 4 advocated the use of amplified V-Y flaps for reconstruction of nasal defects in 11 patients with different nasal areas, especially the nasal tip, while in our study it was the dorsum and sidewall of the nose to be mostly reconstructed. Park also noticed that the complication as partial tip necrosis of the flap was in the tip region of the nose while in our study these complications were encountered in the dorsum and the sidewall regions.…”

“…For patients with large defects involving the nose, a simple local flap cannot be used for reconstruction. Consequently, it is difficult to achieve a good aesthetic outcome with adequate contrast and inconspicuous scars at the borders of aesthetic subunits 2 Amplified V-Y Flaps For Nasal Defect Reconstruction: Park on1998 4 , described this flap for closure of up to 2.5 cm defect on the nose. The addition of an amplified limb as a transposition flap onto the advancing edge of the V-Y flap is considered.…”