Use of Bilaterally Pedicled V-Y Advancement Flap for Reconstruction of the Nose

The bilaterally pedicled V-Y advancement flap was introduced by Pontes in 2002 with clinical applications for facial reconstruction [1]. Here we present the use of a bilaterally pedicled V-Y advancement flap for reconstruction of the nose following excision of a recurring basal cell carcinoma in a 97year-old patient. The bilaterally pedicled V-Y advancement flap is based on two subcutaneous pedicles that vascularize the skin island through subdermal plexus lateral bridges. It differs from traditional V-Y advancement flaps in that it does not rely on the classic subcutaneous vertical pedicle that is sectioned from top to bottom to improve advancement of the skin island based only on its bilateral pedicles. A 97-year-old man presented with a recurrence of a basal cell carcinoma 2.5 cm in diameter and located on the lower half of the nasal dorsum (Fig. 1). A bilaterally pedicled V-Y advancement flap was designed from the frontal region to the upper half of the nasal dorsum (Fig. 2). The recipient site determined the size of the flap and an isosceles triangle resulted when the flap was designed. The height (H) of the triangle which is the length of the V-Y flap, is calculated as follows