Reconstruction of Transition Zone Helical Defects Using a Modified V-Shaped Advancement Flap With 2-Year Follow-Up

Basal cell carcinoma (BCC) on the ear is much more common in men. The helix is the most common subunit for skin cancers on the auricle, and specifically, the superior helix is the most common sublocation for these tumors. However, BCC localized to the lower third of the helix presents a unique reconstructive dilemma. This clinical report presents a modified, bidirectional V-shaped advancement flap designed for this structural transition zone. By altering the vector of tension and recruiting tissue from the adjacent middle helix and lobulus, this single-stage technique avoids auricular cupping and preserves natural ear shape, as validated by a 2-year long-term follow-up.