V-Y Advancement Flaps Based on Yotsuyanagi Aesthetic Subunit Principles for Small Nasal Defects in Asian Patients.

Cosmesis is paramount in the reconstruction of small nasal defects. Yotsuyanagi et al have previously described nasal aesthetic subunits in patients of Asian descent and their implications for reconstruction of large nasal defects, including forehead flap and Z-plasty. The impact of Asian skin types and aesthetic subunits on reconstruction planning of small nasal defects has not been rigorously explored. The aim of this article is to present a novel method for repairing small nose defects in patients of Asian descent using V-Y advancement flap designed using Yotsuyanagi nasal subunit aesthetic principles. A total of 21 defects ranging from 7 to 22 mm in size in 21 patients of Asian descent were repaired with either 1 or 2 V-Y advancement flaps designed along Yotsuyanagi nasal subunit borders. All reconstructions were completed successfully in one stage. Scars were inconspicuous and nasal subunits were neither displaced nor twisted. All patients were pleased with the cosmetic outcomes. The use of V-Y advancement flaps based on Asian aesthetic nasal subunit principles for the reconstruction of small nasal defects is a novel, cosmetically sensitive alternative.