title: A useful flap combination in wide and complex defect reconstruction of the medial canthal region: Glabellar rotation and nasolabial V-Y advancement flaps.
abstract: BACKGROUND
  Reconstruction of medial canthal defects after tumour excision is difficult owing to the thin skin of the region and the concavity of the anatomical landmarks, which enclose complex structures such as the medial canthal ligament and the lacrimal system. Local reconstruction methods for this region include secondary healing, full-thickness skin grafts, and skin flaps from the frontal, transnasal, glabellar and upper eyelid regions.
  
  
  OBJECTIVE
  To demonstrate a useful combination of two local flaps in wide defects of the medial canthal region.
  
  
  METHODS
  Between 1998 and 2012, a combination of glabellar rotation and nasolabial V-Y advancement flaps were used in 11 patients with wide complex defects after excision, including periosteum, of invasive basal cell carcinoma.
  
  
  RESULTS
  All patients were tumour free and underwent functional and aesthetic reconstruction of the medial canthal region. There were no major complications, and no relapses were observed.
  
  
  CONCLUSIONS
  This technique achieves good match in colour and texture, and has satisfactory results both aesthetically and functionally. In addition, donor area morbidity is minimal and surgical technique is simple.
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Department, University of Cukurova Balcalı Hospital, Adana, Turkey.
authors.forename: Erol
authors.initials: E
authors.lastname: Kesiktas
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Department, University of Cukurova Balcalı Hospital, Adana, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Eser
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Department, University of Cukurova Balcalı Hospital, Adana, Turkey.
authors.forename: Eyüphan
authors.initials: E
authors.lastname: Gencel
authors.affiliation: Plastic Reconstructive and Aesthetic Surgery Department, University of Cukurova Balcalı Hospital, Adana, Turkey.
authors.forename: Emrah Efe
authors.initials: EE
authors.lastname: Aslaner
keywords: Glabellar flap; Medial canthal recontruction; Nasolabial flap