Ersin Yavuz, Alp Ercan
Cerrahpaşa Medical Journal - 2025;49(1):1-7
Objective: Frontotemporal reconstruction after malignant tumor excision poses aesthetic and functional challenges due to the region's complex anatomy and visibility. This study aimed to compare outcomes of V-Y advancement flaps vs. full-thickness skin grafts in moderate midtemporal defects. Methods: A retrospective review was conducted on patients who underwent excision of squamous cell carcinoma or malignant melanoma. Defects were reconstructed with either V-Y advancement flaps or full-thickness skin grafts. Aesthetic outcomes were assessed 1 year postoperatively using the FACE-Q Aesthetic Module, evaluated by patients, a plastic surgeon, and a non-plastic specialist. Results: A total of 14 patients (7 V-Y advancement flap, 7 full-thickness skin graft) were included. The V-Y flap group showed significantly higher FACE-Q scores for skin texture, color match, and facial expression, especially within the "facial expression and emotional state" domain. No significant difference was found in the "psychological function" domain. The V-Y technique preserved regional mobility, avoided donor site morbidity, and minimized risk to the frontal branch of the facial nerve. No complications or recurrences were reported. Conclusion: V-Y advancement flaps offer a safe, effective, and aesthetically superior option for selected frontotemporal defects, especially when patient emotional expressiveness and facial harmony are critical. They may be preferred over skin grafts in appropriately selected cases.
