V-Y Advancement Flap in Mid-Temporal Defect Reconstruction After Mohs Surgery.

Area of Science:

• Dermatology
• Plastic Surgery
• Oncology

Background:

• Mid-temporal defects from Mohs surgery present unique anatomical challenges.
• Reconstructing these defects requires careful consideration of functional and aesthetic outcomes.
• The temporal branch of the facial nerve is vulnerable during surgery in this region.

Purpose of the Study:

• To describe the successful treatment of a large mid-temporal squamous cell carcinoma using Mohs micrographic surgery.
• To highlight the utility of local flaps, specifically the V-Y advancement flap, for reconstruction of significant temporal defects.
• To emphasize the importance of meticulous surgical technique in preserving flap viability and patient outcomes.

Main Methods:

• Mohs micrographic surgery for a 4.2-cm invasive squamous cell carcinoma in the left mid-temporal region.
• Tumor clearance achieved in 5 stages.
• Reconstruction utilizing a local flap technique (V-Y advancement flap).

Main Results:

• Complete tumor clearance was achieved.
• The V-Y advancement flap successfully reconstructed the large temporal defect.
• Functional and aesthetic outcomes were optimized.

Conclusions:

• Primary closure is often infeasible for large temporal defects due to limited skin elasticity.
• Local flaps, skin grafts, or combined approaches are viable reconstructive options.
• The V-Y advancement flap is a suitable technique for large mid-temporal defects, requiring careful planning and execution to ensure flap viability.