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. 2020 Aug 11;8(8):e3040.
doi: 10.1097/GOX.0000000000003040. eCollection 2020 Aug.

V-Y Flap for Nasal Reconstruction

Enrique J Viciana  1 , Anne-Sophie Lessard  2
Affiliations

V-Y Flap for Nasal Reconstruction

Enrique J Viciana et al. Plast Reconstr Surg Glob Open. .

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.

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Figures

Fig. 1.
Fig. 1.
Preoperative view of a 39-year-old, fair-skinned white woman with premalignant pigmented changes on the nasal tip.
Fig. 2.
Fig. 2.
Preoperative view of the patient’s nasal tip with margins of the lesion marked. The flaps are marked oriented transversely.
Fig. 3.
Fig. 3.
Early postoperative view of the patient at 2 weeks.
Fig. 4.
Fig. 4.
Late postoperative view of the patient with imperceptible scars at 6 weeks.
Fig. 5.
Fig. 5.
An elderly man with malignant actinic changes on the nasal tip.
Fig. 6.
Fig. 6.
View of the nasal tip of the elderly man at 2 weeks following bishop’s miter flap reconstruction.
See this image and copyright information in PMC

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