V-Y Flap for Nasal Reconstruction

Abstract

The nasal tip is a complex zone for reconstruction. Numerous flap reconstructions have been proposed. In addition to the technique presented here, only the Gillies-Millard bishop’s miter flap and the paramedian forehead flap should be considered. The bilobed flap should be discontinued. The double-opposing V-Y flap for nasal tip reconstruction described here is an excellent method for reconstruction of limited defects of the nasal tip. These are mirror-image cutaneous flaps which require careful, skillful technique to preserve the delicate nerves and vessels. This challenging technique should only be attempted by qualified surgeons. Triangular cutaneous flaps are marked on either side of the defect, oriented transversely. The flaps are elevated and advanced with careful, gentle dissection. Ligamentous structures are cut while preserving the neurovascular supply. No cautery is used. The procedure is performed in an operating room with local anesthesia and with the patient under IV sedation. A patient who underwent this reconstruction is shown preoperatively, early postoperatively, and late postoperatively. The results demonstrate no tip distortion with imperceptible scars. The steps to undertake this procedure are outlined in detail. Rules for nasal tip reconstruction are proposed.

Repairing Small Facial Soft Tissue Defects by Tissue Regeneration in Asians

“…Skin graft has been rarely used in the repair of small facial soft tissue defects because of its differences in color, texture, and thickness between the skin graft and the recipient area. Local flap is widely used in the repair of various types of facial soft tissue defects due to its similar texture and color, such as banner flap,4 note flap,5 bilobed flap,6 and V-Y advancement flap 7. However, the local skin flap requires an auxiliary incision.…”

“…Local flap is widely used in the repair of various types of facial soft tissue defects due to its similar texture and color, such as banner flap, 4 note flap, 5 bilobed flap, 6 and V-Y advancement flap. 7 However, the local skin flap requires an auxiliary incision. Even if the incision is very neat, it will inevitably leave the incision scar after healing.…”