Large V-Y Island Facial Flap Reconstruction Left Temporal Defect

Mokhtar Asaadi

Department of Surgery, Saint Barnabas Medical Center, USA

*Correspondence to: Dr. Mokhtar Asaadi, Department of Surgery, Saint Barnabas Medical Center, USA.

Copyright © 2019 Dr. Mokhtar Asaadi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The patient is a 63-year-old male with ulcerated lesions of the left temporal and zygomatic areas for more than seven years. The patient had a biopsy done by a dermatologist previously, which showed Basel Cell Carcinoma and was concerned about the cosmetic appearance after surgery. The possibility of facial nerve damage during surgery and at the time of reconstruction was discussed pre-operatively.

On physical examination, he had three ulcerated lesions of the left zygomatic and temporal areas measuring about 5cm in diameter. There were no palpable cervical lymph nodes. X-Rays of the underlying bones were normal.

Under general anesthesia excision of the Basal Cell Carcinoma of the left temporal and zygomatic area were done. The defect measured about 7cm by 4 ½ cm in size. Immediate frozen section was done from the margins and also from the deepest portion of the specimen. All margins were negative. Diagnosis was Basal Cell Carcinoma. Reconstruction was done using a left temporal flap based on the superficial temporal artery and a V-Y Island advancement from the left side of the face and primary closure of the donor site.

The post-operative course was smooth. In subsequent office visits and follow-up there was no evidence of facial weakness. The scars are healing well and are gradually fading. The patient is pleased with the results of surgery.

Conclusion
Large facial V-Y Island flap when designed properly can cover large facial defect because of the perforating vessels without the use of the skin graft.

This type of flap cannot be done on the scalp or other parts of the body when there are not adequate perforating vessels.