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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. To review the design and execution of advancement flaps in facial reconstruction. A review of the literature on the use of advancement flaps in facial reconstruction was performed and curated with the authors' experience. Many factors come into play when using local flaps to reconstruct surgical defec