Dermatosurgical rounds: double opposing rotational advancement (Ying-Yang) flap for reconstruction of primary defects following skin cancer excisions in the medial foot ankle and preauricular regions.

Surgical reconstructive techniques continue to evolve as dermatosurgeons combine clinical expertise, technical skill, and innovation. In some cases, such innovation can result in better outcomes in terms of tension management, vascular supply preservation, and esthetic appearance. The double-opposing rotation advancement flap, also known as the Ying-Yang flap due to its yin-yang mode of action, is often applied in the scalp region, where it provides excellent results with minimal complications. However, data supporting its application in less conventional anatomical sites remains limited. We present two independent cases involving primary defects resulting from skin tumor excisions, successfully reconstructed with the Ying-Yang flap in atypical locations: the medial foot ankle and preauricular regions. Tension-free closure was achieved in both cases, and follow-up at two months demonstrated great wound healing. While surgical excision remains the gold standard for treating skin cancer, these cases highlight the double-opposing rotation advancement flap as a versatile and effective reconstructive option beyond its standard indications.