title: [Horizontal V-Y advancement flap for lower eyelid reconstruction in young patients].
abstract: OBJECTIVE
  The reconstruction of lower eyelid defects is a complex issue because of the thinness of eyelid tissues and the need for protection of the globe. The surgery must address two requirements: a functional goal, avoiding eyelid malposition, and a cosmetic goal, limiting aesthetic compromises. In young patients, direct closure is rarely possible if the defect is superior to 1cm. The horizontal V-Y advancement flap is a simple and reliable method but is hardly ever reported. The purpose of this study is to review the surgical technique and report our experience with this flap in the reconstruction of younger patients.
  
  
  METHODS
  Nine patients, 5 men and 4 women, with a mean age of 54 years, underwent a lower eyelid reconstruction by horizontal V-Y advancement flap between 2011 and 2014. In every case, the initial pathology was a basal cell carcinoma and the surgical margins were uninvolved. The mean diameter of the surgical defect was 1.9 centimeters and the average procedure duration was 40 minutes.
  
  
  RESULTS
  All patients were managed as outpatients. Functional and aesthetic results were judged satisfactory or very satisfactory by all the patients and their surgeon. No flap necrosis and no ectropion or scleral show were reported. In one patient, lower lid edema lasted until the third postoperative month.
  
  
  CONCLUSIONS
  The horizontal V-Y advancement flap enables to repair lower eyelid defects using nearby skin of similar characteristics. Aesthetic results are very satisfactory, and scars, concealed in the eyelid creases, are nearly invisible in the long term. The lack of tension on the eyelid margin limits the risk of eyelid position. This simple and reliable one-step procedure, possible under local anesthesia, is appropriate for young, active patients, limiting the cosmetic sequelae and social ramifications.
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France.
authors.forename: F
authors.initials: F
authors.lastname: Lize
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France.
authors.forename: P
authors.initials: P
authors.lastname: Leyder
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, centre hospitalier Robert-Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France; Service de chirurgie, groupe hospitalier Avicenne-Jean-Verdier, université Paris Nord, 125, route de Stalingrad, 93000 Bobigny, France. Electronic address: julien.quilichini@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Quilichini
mesh_terms: D002280:Basal Cell Carcinoma / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps
keywords: Cancer cutané; Eyelid reconstruction; Flap; Lambeau; Muscle orbicularis oculi; Orbicularis oculi muscle; Paupière; Reconstruction; Skin cancer