Background: Advancement flaps are random-pattern flaps frequently used in the reconstruction of surgical defects on the face after the removal of skin cancer. Proper design and meticulous execution is crucial in achieving reproducible esthetic results.
Objective: To review the design and execution of advancement flaps in facial reconstruction.
Materials and methods: A review of the literature on the use of advancement flaps in facial reconstruction was performed and curated with the authors' experience.
Conclusion: Many factors come into play when using local flaps to reconstruct surgical defects on the face. Close attention must be given to the tissue surrounding the surgical defect and any free margin in the area. Designing the flap closure lines along cosmetic unit junctions and or relaxed skin tension lines, preserving both the form and function of the surrounding structures, and using excellent surgical techniques during the closure will all together help in providing reproducibly outstanding results.