# Step ladder VY advancement flap for lower eyelid reconstruction after resection eyelid malignant tumors

## TL;DR

A new surgical technique called the step ladder V–Y advancement flap is introduced for reconstructing the lower eyelid after removing large malignant tumors, offering benefits like reduced operating time and fewer complications.

## Contribution

The paper introduces the step ladder V–Y advancement flap as a novel surgical technique for lower eyelid reconstruction after tumor removal.

## Key findings

- The step ladder V–Y advancement flap was successfully used in five patients without complications like ectropion deformity.
- The flap requires minimal dissection and preserves healthy skin, making it efficient and aesthetically favorable.

## Abstract

In oculoplastic surgery, reconstruction of a large defect after the removal of a massive malignant lower lid tumor still represents a unique challenge. We will report on this case, including a presentation of the case using step ladder V–Y advancement flap.

During November 2018 to March 2023, five patients of lower eyelid malignant tumor had wide resection with safety margin and reconstructed using step ladder V–Y advancement flap. The flap was used step ladder V–Y advancement flap.

No complications, including ectropion deformity, occurred. This flap does not sacrifice healthy skin as seen with the cheek rotation flap, and the area of dissection is very small and can be performed in a short time.

Step ladder V–Y advancement flap is highly useful in cases that require a reconstruction of a large defect after the removal of a massive malignant lower lid tumor from viewpoints of operating time, ease of procedure, aesthetics, and complications.