Pre-Operative Considerations
- Local anesthetic for patient comfort in office setting
- If the scar bed is too wide (ie ‘D’ in the above image is too long), it will be difficult to achieve closure of the Y-limb
- A small apex angle results in a long but narrow donor site defect, while a large apex angle results in a short but wide donor site defect.
- If the available surface area is limited by a nearby aesthetic landmark, the apex angle must be made larger so as to minimize flap length. However, tissue laxity must be sufficient enough to accommodate the wider donor site defect that occurs with a larger apex angle.
- If tissue laxity is poor, the apex angle can be made smaller to minimize the width of the donor site. However, the adjacent surface area must be sufficient enough to accommodate the longer flap that occurs with a smaller apex angle.
