Laterally Based Island Pedicle Flap with Cheek Advancement for Defects of the Nasal Ala.

V-to-Y advancement flap is a successful repair technique that preserves vascular and tissue integrity adopted after Mohs micrographic surgery to repair cutaneous defects on the head and neck. However, defects at the lateral distal nasal ala requires large extension beyond cosmetic margins that increase risk of skin webbing, an undesired result on a cosmetically sensitive location to the patient. In this article, we present a novel approach to modifying the procedure employing the V-to-Y advancement flap by truncated the trailing end of the island pedicle to allow for successful healing and better patient satisfaction.