Innovative Use of Bilateral Pedicle Advancement Flap for Post-auricular Defect Reconstruction

In the field of reconstructive dermatological surgery, managing extensive defects in regions characterized by limited skin elasticity and exposed cartilage after Mohs surgery presents significant challenges. Unique situations arise where primary closure is impractical due to the size and/or location of the defect, necessitating alternative, complex reconstructive techniques. These techniques allow surgeons to preserve structural integrity and optimize aesthetic results. In this case, a 78-year-old white male presented with a nodular basal cell carcinoma on the right posterior auricle. He underwent Mohs surgery, which resulted in a 1.5 x 1.5 cm defect. The authors used a bilateral pedicle advancement flap, a technique not commonly used in dermatologic surgery, to close the resulting defect. This approach resulted in an excellent surgical outcome with no complications at the 10-month follow-up. This case highlights the bilateral pedicle advancement flap as a viable and effective reconstruction method for small to mid-sized posterior auricular defects.