AESTHETIC CONSIDERATIONS IN FACIAL RECONSTRUCTIVE SURGERY - THE V-Y FLAP REVISITED

The subcutaneous pedicled V-Y advancement flap (also known as the ''ki te flap'' of Dufourmentel) has been described by many authors. Its ver satility in reconstructive surgery is well known, both in facial recon structive surgery as well as surgery of the trunk and extremities. Its advantages in achieving aesthetic reconstruction in specific facial r egions have been less well emphasized in the literature. The flap can be designed within natural facial creases and heals inconspicuously be cause of its widely based subcutaneous or muscle pedicle which incorpo rates venous and lymphatic drainage over most of its length. The undes irable ''biscuiting'' or flap edema frequently observed with other con ventional transposition flaps is avoided. We have found the V-Y flap p articularly useful in reconstructing the lower eyelid/medial canthus, supra-alar, and nasolabial regions. Our experience with over 40 such f laps is described, and technical considerations in designing and eleva ting the flap are discussed.