V to Y advancement flap- a novel approach for earlobe reconstruction

The V to Y advancement flap is a useful modality for repairing a variety of skin defects. Its use is well described in the literature. The flap is designed to transfer skin from an area of relative excess to fill a neighbouring defect. It is a versatile local advancement flap that is technically straightforward and can vary markedly in size.

This technique may impact the practice of a wide international target audience of clinicians who perform excision and reconstruction of auricular defects in practice, including but not limited to dermatologists, plastic and facial plastic surgeons, otolaryngologist-head and neck surgeons, as well as general practitioners, particularly those who may perform outpatient procedures in more rural settings.

Hence, Laura Allen and colleagues from the Division of Otolaryngology – Head & Neck Surgery, Department of Surgery, University of British Columbia, British Columbia, Canada aimed to describe the use of the V to Y flap in 6 Caucasian patients with non-melanoma skin cancer of the earlobe.

A review of the literature was performed on the use of the V to Y flap for earlobe reconstruction. The authors described its use in reconstructing lobular defects in 6 patients. All patients had a non-melanoma skin cancer involving the earlobe.

All surgeries were performed under local anesthetic at a tertiary care centre. Defects ranged in size from 1.0 to 1.4 cm. All defects were reconstructed with only a V to Y advancement flap. Patient photographs were taken intra-operatively and post-operatively. For all patients, satisfaction of the final aesthetic result was assessed on a 10 point scale in follow-up at 6 months.

The study revealed the following findings-

1. The method was well tolerated under local anesthetic in 6 patients with non-melanoma skin cancers of the earlobe.
2. All patients reported an aesthetically satisfying result at 6 months with scores ranging between 8 and 10.
3. Scarring in all cases was minimal.

Therefore, it was concluded that "The V to Y advancement flap is a simple technique for reconstructing small defects of the lobule. This method is technically straight-forward, poses minimal risk to the patient, and in our experience, yields a favourable cosmetic outcome."