Introduction/Background Surgical treatment of vulvar cancer can lead an important defect to consider a direct skin closure without flap reconstruction.We present a case of a 75-year-old patient diagnosed with squamous cells carcinoma of the vulva localized in the left labium minus, the prepuce of the clitoris, the right labium minus, in contact with urethra and vagina without invasion requiring anterior vulvectomy with bilateral sentinel node.

Methodology Vulvar reconstruction was performed using a perforator-based island pedicle flap, the Singapore flap also called internal pudendal perforator flap, to recreate internal face of labia majora, vestibule and fill the space of the labia minora.At the same time, we performed clitoral reconstruction using Foldès Technique, described to restore the clitoral anatomy in patients who undergone genital mutilation.

Results Post-operative care consisted in 3 days wound drainage and bladder catheterization for 10 days. Patient was discharged at 7th postoperative day without major complication.

Conclusion Bilateral Singapore island perforator flap is a reliable flap who maintain vulvar cosmesis with minimal donor site-mobidity.