Background: V-Y advancement flap (VYAF) is a commonly used flap for facial reconstruction, but it is not popular in Asian society with limited aesthetic outcome evaluation.
Objective: Demonstrate our experience of facial VYAF with the quantitative aesthetic outcome assessment.
Methods & Materials: From January 2013 to December 2022, patients who underwent facial VYAF recon-struction were reviewed. Postoperative photographs were collected and independently graded by three plastic surgeons using the observer component of the Patient and Observer Scar Assessment Scale (POSAS). The representative preoperative images were selected for surgeons’ reconstruction preferences survey.
Results: Forty-eight patients (27 females and 21 males), with a mean age of 66.8 (23–97) years, were included in this study. All flaps survived with no flap necrosis. Only a few patients developed postoperative complications, and they were treated conservatively and resolved uneventfully. The total POSAS score was 8.6 ± 2.4 (scale of 5 [normal skin] to 50 [worst scar imaginable]) and the overall scar appearance rating was 1.9 ± 0.6, indicating satisfactory postoperative scar condition. From the survey of 22 plastic surgeons and 11 scenarios, VYAF were rarely chosen among other local flaps which only accounted for 8.7%.
Conclusion: VYAF is an easy and safe method for facial reconstruction with low morbidity but its usefulness is underappreciated. With a proper design and cautious dissection, we believe that good aesthetic and functional outcomes can be achieved with VYAF.

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