Bilobed Flap
Facial and Ear Reconstruction With a Scalp Advancement Flap and Forehead Flap, Skin Cancer, Kevin Kavanagh
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  • Slide 1. Ear Reconstruction - Stage 1The patient had a large ear defect created by Mohs surgery for resection of a squamous cell carcinoma.
  • Slide 2. Ear Reconstruction - Stage 1The patient had a large ear defect created by Mohs surgery for resection of a squamous cell carcinoma.
  • Slide 3. Ear Reconstruction - Stage 1An advancement flap to cover the ear defect is outlined on the post-auricular scalp.
  • Slide 4. Ear Reconstruction - Stage 1nstructionThe anterior margin of the scalp defect is sewn to the posterior margin of the ear defect. This forms a tube of skin.
  • Slide 5. Ear Reconstruction - Stage 1The anterior margin of the scalp defect is sewn to the posterior margin of the ear defect. This forms a tube of skin.
  • Slide 6. Ear Reconstruction - Stage 1The scalp flap is advanced over the anterior portion of the ear defect and sewn into position.
  • Slide 7. Ear Reconstruction - Stage 1The immediate appearance of the ear after the first stage of reconstruction. Note a drain is placed into the area of the scalp defect.
  • Slide 8. Ear Reconstruction - Post-Op Stage 1The appearance of the ear one week after surgery.
  • Slide 9. Ear Reconstruction - Post-Op Stage 1The appearance of the ear 40 days after surgery. At this point the patient wanted to postpone the second stage reconstruction.
  • Slide 10. Ear Reconstruction - Post-Op Stage 1The appearance of the ear 10 weeks after surgery. At this point he has consented to the second stage reconstruction.
  • Slide 11. Ear Reconstruction - Stage 2The second stage consists of elevation of a scalp flap from the post-auricular region. This flap will cover the posterior surface of the auricle and is sewn into the skin tube (metal probe).
  • Slide 12. Ear Reconstruction - Stage 2The skin flap is sewn into the opened skin tube and the auricle has been reconstructed. A large donor defect is present on the scalp.
  • Slide 13. Ear Reconstruction - Stage 2The donor defect is closed using a superior scalp and inferior neck rotation advancement flaps.
  • Slide 14. Ear Reconstruction - Stage 2The flaps are elevated and sewn into position.
  • Slide 15. Ear Reconstruction - Stage 2The appearance of the scalp and ear immediately after completion of the second stage operation.
  • Slide 16. Ear Reconstruction - Stage 2The appearance of the ear immediately after completion of the second stage operation. The excess and bulk of the auricular tissue will slowly thin and atrophy in the postoperative period. This process may take many months.
  • Slide 17. Ear Reconstruction - Post-Op Stage 2The appearance of the ear one week after the second operation.
  • Slide 18. Ear Reconstruction - Post-Op Stage 2The appearance of the ear one week after the second operation.
  • Slide 19. Ear Reconstruction - Post-Op Stage 2The appearance of the ear four weeks after the second operation.
  • Slide 20. Ear Reconstruction - Post-Op Stage 2The appearance of the reconstructed ear as compared to the opposite ear, looking straight at the patient.

Scalp Advancement Flap for Ear Reconstruction
in a Patient who had Resection of a Skin Cancer
  

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