• Archives of Plastic Surgery
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• v.49 no.1
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.619-625
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• 2012

Background After skin tumor excision on the face, extremities, or trunk, the choice of treatment for a skin defect is highly variable. Many surgeons prefer to use a local flap rather than a skin graft or free flap for small- or moderately-sized circular defects. We have used unilateral or bilateral V-Y advancement flaps, especially on the face. Here we evaluated the functional and aesthetic results of this technique. Methods All of the patients were pathologically diagnosed with squamous cell carcinoma (SCC), basal cell carcinoma (BCC), or malignant melanoma or premalignant lesion (Bowen's disease). Thirty-two patients underwent V-Y advancement flap repair (11 unilateral and 21 bilateral) from January 2007 to June 2011. We analyzed the patients' age and satisfaction, and location and size of defect. The patients were followed up for 6 months or more. Results There were 22 women and 10 men. The ages ranged from 47 to 93 years with a mean age of 66 years. The causes were SCC in 15 cases, BCC in 13 cases, malignant melanoma in 1 case, Bowen's disease in 2 cases, and another cause in 1 case. The tumor locations were the face in 28 patients, and the scalp, upper limb, and flank each in one patient. All of the flaps survived and the aesthetic results were good. Postoperative recovery was usually rapid, and no complication or tumor recurrence was observed. Conclusions The V-Y advancement flap is often used not only for facial circular defects but also for defects of the trunk and extremities. Its advantages are less scarring and superior aesthetic results as compared with other local flap methods, because of less scarification of adjacent tissue and because it is an easy surgical technique.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.7-13
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• 2014

Background: Cryptotia correction by V-Y advancement of a temporal triangular flap was introduced in 2005. However, despite the several advantages of V-Y advancement, visible scars at the donor site are problematic. As a result, a Z-plasty technique was considered for skin deficiency in mild cases. Therefore, we introduce a new surgical scheme for cryptotia correction based on considerations of techniques and complications that arose in our clinic. Methods: Between 2000 and 2013, 26 patients (35 cases) of cryptotia were treated. Seventeen patients had unilateral cryptotia and nine had bilateral cryptotia. Two corrective methods were used, Z-plasty or V-Y advancement, based on the severity. In mild cases, Z-plasty was used for correction and in severe cases, V-Y flap advancement was used for more skin supplement. Results: Follow-up periods ranged from 6 months to 1.5 years. The results obtained were relatively favorable. Nine cases of mild deformity were corrected by Z-plasty, and the other 26 cases with mild or severe deformities were corrected by V-Y advancement. In Z-plasty cases, there was one hypertrophic scar and in V-Y advancement cases, seven resulted in visible scarring and three in skin sloughing. Conclusion: The main advantage of Z-plasty is a lower likelihood of visible scarring at the donor site. In mild cases, Z-plasty may be a good alternative, but in severe cases, V-Y advancement is probably the best option for more skin supplement.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.26-29
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• 2023

Cryptotia is a rare congenital auricular deformity among Caucasians but more common in Asians. Various operative techniques have been described, such as skin graft, V-Y plasty, Z plasty, and islands skin flap. Among those techniques, V-Y plasty has many advantages and is indicated for severe cases. However, several problems remain when this method is adopted, such as conspicuous scars and lowered hairline. To overcome these problems, the authors have developed a new technique, multiple V-Y advancement modification, which stitches the skin flaps together to a tight, discrete central focal point. This technique has the advantage of hiding scars behind the earlobe, providing enough skin for the deformed areas, minimizing the condition of the hairline being lowered and auriculocephalic sulcus depth.

• Journal of Korean Foot and Ankle Society
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• v.4 no.2
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• pp.87-92
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• 2000

The tendinous ends of neglected achilles tendon rupture tend to retract and separate with atrophy due to gastrosoleus muscle contracture, leaving a wide gap occupied with fibroadipose scar tissue. It is almost impossible to perform simple end-to-end anastomosis after the intervening scar tissue being excised. Therefore many surgical procedures have been proposed to reconstruct the large gap. We treated three such cases by V-Y advancement flap and double Krackow suture technique, and their postoperative strength of triceps surae were evaluated with Cybex isokinetic strength testing. All patients returned to preinjury activities with satisfaction, but the ankle plantar flexor power showed about 20-30% deficit.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.200-204
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• 2009

Purpose: The epicanthal fold is a unique finding in the medial canthal area of many Asians. Various methods have been developed to eliminate this fold. However, excessive and prominent scarring in the medial canthal and nasal area and recurrence restricted application of epicanthoplasty. The authors performed a epicanthoplasty using Y-V advancement flap method in order to obliterate the epicanthal fold without making incisions in the nasal area and as a result, to avoid postoperative scarring. Methods: Sixty one patients underwent epicanthal fold correction using Y-V advancement flap method from July 1999 to February 2005. There were 4 males and 57 females with ages ranging from 9 to 60 years. The epicanthoplasty was performed combined with double eyelid operation, ptosis correction, augmentation rhinoplasty, nasal alar reduction, and nasal tip-plasty. Results: There were few complications in our studies, and most of the patients were satisfied with the results. Conclusion: Remarkable advantages of our Y-V advancement flap epicanthoplasty are as follows: 1) minimal postoperative scarring in the medial canthal area, 2) application of modified double eyelid operation, 3) wider opening of the medial palpebral fissure, 4 the correction of entropion or epiblepharon, 5) no recurrence.

• Archives of Plastic Surgery
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• v.37 no.6
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• pp.823-826
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• 2010

Purpose: Meningomyelocele is the most common type of neural tube defect disease. Early surgical treatment is recommended to prevent central nervous system infection. Several reconstruction methods were reported previously regarding surgical wound defect closure following meningomyelocele excision. In this article, we report two successful patients using the bilateral fasciocutaneous sliding V-Y advancement flap as a covering for meningomyelocele defects. Methods: Two patients with meningomyelocele were evaluated. Both patients were male and received their operations on the 1st and 4th day of life. After neurosurgeons completed their part of the operation, the V-Y advancement flap was used to close the defect. Initially a bilateral V-shape incision design was made on the skin such that the base of the V-flap measures identical to the size of the wound defect. An incision was made down to the fascia in order to allow the V-flaps to slide into the defect. Subfascial dissection was performed up to 1/3 to 1/4 the length of the V-flap from the wound while minimizing injury to the perforating vessels. Results: Both patients were treated successfully and there was no evidence of complication in 2 months follow up. Conclusion: Several reconstruction methods such as local flaps, skin graft and myocutaneous flaps were reported regarding meningomyelocele surgical wound defect closure. Bilateral fasciocutaneous sliding V-Y advancement flap is an easy method without involving the underlying muscles or a secondary skin graft in a short operation time. Therefore we recommend this treatment option for reconstruction of the wound defect following meningomyelocele excision.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.614-621
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• 2021

Background Reconstruction of congenital microtia remains challenging, particularly in patients with a history of ear canaloplasty due to insufficient regional soft tissue. The insertion of a tissue expander prior to implantation of the cartilage framework has traditionally been employed. However, this procedure could induce additional morbidity. Herein, we present a method using V-Y advancement of a temporal triangular flap to gain additional soft tissue in these challenging cases. Methods Congenital microtia patients with a history of ear canaloplasty who underwent auricular reconstruction using the Nagata technique between 2016 and 2020 were reviewed. To obtain additional soft tissue, V-Y advancement of a temporal triangular flap was performed concurrently with implantation of the costal cartilage framework, without prior insertion of a tissue expander. The outcomes of these patients with respect to postoperative complications and esthetics were evaluated. Results Eight patients with bilateral lesions were included. No specific complications developed after the first-stage surgery. However, one patient experienced complications after the second stage (auricular elevation). An analysis of the esthetic results showed most patients had excellent outcomes, achieving a satisfactory convolution. The median number of operations needed to complete reconstruction was 2, which was fewer than required using the conventional method with prior insertion of a tissue expander. Conclusions In patients with a history of previous canaloplasty, V-Y advancement of a temporal triangular flap could serve as an alternative to tissue expansion for microtia reconstruction. This technique provided reliable and satisfactory results with a reduced number of surgical stages.

• Archives of Plastic Surgery
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• v.34 no.5
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• pp.641-646
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• 2007

Purpose: Lateral canthoplasty is utilized in aesthetic surgery to lengthen the lateral palpebral fissure of the lateral canthal area. However, complication such as recurrence, contour deformity or hypertrophic scar make its results doubtful. Therefore, we developed lateral canthoplasty with lateral canthotomy and Y-V advancement to effectively lengthen the palpebral fissure without recurrence. Methods: A total number of 117 patients were reviewed from March 1991 to April 2005. The operative procedure was lateral canthoplasty with lateral canthotomy and Y-V advancement. To prevent recurrence, we dissected lateral conjunctiva of lower eyelid. The author believes that by this procedure, V flap would be able to advance laterally without tension. Results: We performed lateral canthoplasty in 117 patients. There were no recurrence and patients were satisfied with the results. There were 12 patients who presented with complication. Complication included hypertrophic scar in 4 patients, web formation in 3 patients and over-correction in 5 patients. Conclusion: Lateral canthoplasty with lateral canthotomy and simple Y-V advancement may be used as an effective method to lengthen palpebral fissure without recurrence.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.27-27
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• 2008