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Use of a Patient and Observer Scar Assessment Scale to Evaluate the V-Y Advancement Flap for Reconstruction of Medial Cheek Defects


  • The authors have indicated no significant interest with commercial supporters.

Address correspondence and reprint requests to: Eduard Raklyar, MD, 16 Kinzel Lane, West Orange, NJ 07052, or email:



The V-Y advancement flap (VYF) is not commonly used to reconstruct defects located on the medial cheek. The quantitative assessment of VYF for this indication has not been reported. In evaluation of surgical scarring, the Patient and Observer Scar Assessment Scale (POSAS) has been validated for use in burn and breast surgery scars, but its usefulness in dermatologic surgery has not been determined.


To present our experience with the use of the POSAS to assess the success of VYF reconstruction for surgical defects on the medial cheek.

Methods and Materials

Fourteen patients with medium to large (>5 cm2) medial cheek Mohs defects reconstructed using VYF were assessed. Final cosmetic and functional results were analyzed after a follow-up of 6 months to 2 years (mean follow-up 21 months) using the POSAS.


Observers using the POSAS gave a mean score for VYF reconstructions of 9.1 ± 2.3 (5 represents normal skin, 50 represents worst imaginable scar). Patients using the POSAS gave a mean score for VYF reconstructions of 10 ± 4 (6 representing normal skin, 60 representing worst imaginable scar).


VYF reconstruction of medium to large defects of the medial cheek is a useful option. The POSAS may be a helpful tool for evaluating reconstructive results in dermatologic surgery.

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