Table of ContentsView AllTable of ContentsPurposeTypes of Flap ProceduresPotential ComplicationsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Purpose
Types of Flap Procedures
Potential Complications
Frequently Asked Questions
Sometimes, the flap consists of skin and fatty tissue only, but a flap may also include muscle from the donor site (the area from which the flap is raised).
This article will review why a flap procedure may be used, as well as the different types of flaps and potential complications from the surgery.
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If you have suffered tissue loss over any area of your body, you may be a candidate for flap surgery. This type of reconstructive plastic surgery is commonly used to repair defects left behind after traumatic injury or following surgical removal of cancer.
These can include:
Flaps come from many different locations and are used in many different ways to accomplish the desired result. However, flaps used for reconstructiveplastic surgerycan be broken down into two main categories.
Pedicle Flap
Tissue is freed and rotated or moved in some manner from an adjacent area to cover the defect, yet remains attached to the body at its base and has blood vessels that enter into the flap from the donor site.
The type of flap movement required determines which of the four main types of local flaps is used.
Free Flap
Tissue from another area of the body is detached and transplanted to the recipient site, and the blood supply is surgically reconnected to blood vessels adjacent to the wound.
Complications possible from flap surgery include general surgical risks such as:
Flap-specific complications can include:
Call your surgeon immediately if you have chest pain, shortness of breath, unusual heartbeat, or excessive bleeding.
Summary
Multiple types of flap procedures can be done, with each having certain benefits for the area of the body where the surgery will be performed.
The surgery is not without risks, however. These risks should be discussed with the plastic surgeon before having the procedure.
A Word From Verywell
Living through a traumatic experience or having a major surgery that leaves you with a physical defect can be emotionally difficult. Flap surgery may improve the way you feel about yourself. It’s important to research plastic surgeons well, and find one that specializes in the type of surgery you need.
Frequently Asked QuestionsBecause flaps have their own blood supply, they are more resilient thanskin graftsand usually produce much better results from a cosmetic standpoint because they can provide a better match for skin tone and texture.Skin flaps are also a better choice when tissue “bulk” is needed to fill contour defects. However, in cases in which there have been very large areas of tissue loss, the use of a skin graft may be necessary.While tissue expansion can produce superior results in terms of matching skin color, texture, and sensation, it has disadvantages. Tissue expansion always requires, at least, two surgical procedures, plus repeated visits to your surgeon to further inflate the expander. In the meantime, the expander is left in place, creating what can in many cases be an unsightly bulge under the skin where the expander is placed. However, in the case ofbreast reconstruction, this extra volume can be desirable.
Because flaps have their own blood supply, they are more resilient thanskin graftsand usually produce much better results from a cosmetic standpoint because they can provide a better match for skin tone and texture.Skin flaps are also a better choice when tissue “bulk” is needed to fill contour defects. However, in cases in which there have been very large areas of tissue loss, the use of a skin graft may be necessary.
Because flaps have their own blood supply, they are more resilient thanskin graftsand usually produce much better results from a cosmetic standpoint because they can provide a better match for skin tone and texture.
Skin flaps are also a better choice when tissue “bulk” is needed to fill contour defects. However, in cases in which there have been very large areas of tissue loss, the use of a skin graft may be necessary.
While tissue expansion can produce superior results in terms of matching skin color, texture, and sensation, it has disadvantages. Tissue expansion always requires, at least, two surgical procedures, plus repeated visits to your surgeon to further inflate the expander. In the meantime, the expander is left in place, creating what can in many cases be an unsightly bulge under the skin where the expander is placed. However, in the case ofbreast reconstruction, this extra volume can be desirable.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Andree C, Munder BI, Seidenstuecker K, et al.Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy.Med Sci Monit. 2012;18(12):CR716-20. doi:10.12659/msm.883598Chorath K, Go B, Shinn JR, et al.Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis.Oral Oncol. 2021;113:105117. doi:10.1016/j.oraloncology.2020.105117Swendseid BP, Roden DF, Vimawala S, Richa T, Sweeny L, Goldman RA, Luginbuhl A, Heffelfinger RN, Khanna S, Curry JM.Virtual surgical planning in subscapular system free flap reconstruction of midface defects.Oral Oncology. 2020; 101. doi: oi.org/10.1016Yellinek S, Krizzuk D, Moreno Djadou T, Lavy D, Wexner SD.Endorectal advancement flap for complex anal fistula: does flap configuration matter?Colorectal Dis. 2019;21(5):581-587. doi:10.1111/codi.14564Christopoulos G, Deraje V, Mbaidjol Z, Kannan RY.The “snail flap”: a rotation flap in scalp reconstruction.Plast Reconstr Surg Glob Open. 2020;8(1):e2599. doi:10.1097/GOX.0000000000002599Taş S.Superior-based transposition flap: a novel technique in rhinoplasty.Aesthet Surg J. 2019;39(7):720-732. doi:10.1093/asj/sjy197Abdelmofeed AM, Salama RS.Different modalities of nasolabial flaps in nasal-defect reconstruction: clinical experience in 40 cases and review of literature.The Egyptian Journal of Surgery. 2021;40(4):1192. doi:10.4103/ejs.ejs_191_21Patel UA, Hernandez D, Shnayder Y, et al.Free flap reconstruction monitoring techniques and frequency in the era of restricted resident work hours.JAMA Otolaryngol Head Neck Surg. 2017;143(8):803-809. doi:10.1001/jamaoto.2017.0304Patel SA, Abdollahi H, Ridge JA, Chang EI, Lango MN, Topham NS.Asymptomatic deep peroneal vein thrombosis during free fibula flap harvest: a review of the literature, strategies for preoperative assessment, and an algorithm for reconstruction.Ann Plast Surg. 2016;76(4):468-71. doi:10.1097/SAP.0000000000000355Gassman AA, Yoon AP, Maxhimer JB, et al.Comparison of postoperative pain control in autologous abdominal free flap versus implant-based breast reconstructions.Plast Reconstr Surg. 2015;135(2):356-67. doi:10.1097/PRS.0000000000000989MacKay BJ, Dardano AN, Klapper AM, Parekh SG, Soliman MQ, Valerio IL.Multidisciplinary application of an external tissue expander device to improve patient outcomes: a critical review.Adv Wound Care. 2020;9(9):525-538. doi:10.1089/wound.2019.1112Additional ReadingTschoi M, Hoy FA, Granick MS.Skin Flaps. Clinics of Plastic Surgery; 2005; April; Volume 32(2), p261-273.Basic Principles of Skin Flaps; Fisher J., Georgaide GS, Georgaide NG, Riefkohl R, Barwick WJ; Textbook of Plastic, Maxillofacial, and Reconstructive Surgery. Volume 1, 2nd edition,1992, p 29-40.Interview with Board Certified Facial Plastic and Reconstructive Surgeon,Andrew Jacono, MD, New York, NY.Skin Cancer and Your Plastic Surgeon, Patient Information Sheet, American Society of Plastic Surgeons.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Andree C, Munder BI, Seidenstuecker K, et al.Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy.Med Sci Monit. 2012;18(12):CR716-20. doi:10.12659/msm.883598Chorath K, Go B, Shinn JR, et al.Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis.Oral Oncol. 2021;113:105117. doi:10.1016/j.oraloncology.2020.105117Swendseid BP, Roden DF, Vimawala S, Richa T, Sweeny L, Goldman RA, Luginbuhl A, Heffelfinger RN, Khanna S, Curry JM.Virtual surgical planning in subscapular system free flap reconstruction of midface defects.Oral Oncology. 2020; 101. doi: oi.org/10.1016Yellinek S, Krizzuk D, Moreno Djadou T, Lavy D, Wexner SD.Endorectal advancement flap for complex anal fistula: does flap configuration matter?Colorectal Dis. 2019;21(5):581-587. doi:10.1111/codi.14564Christopoulos G, Deraje V, Mbaidjol Z, Kannan RY.The “snail flap”: a rotation flap in scalp reconstruction.Plast Reconstr Surg Glob Open. 2020;8(1):e2599. doi:10.1097/GOX.0000000000002599Taş S.Superior-based transposition flap: a novel technique in rhinoplasty.Aesthet Surg J. 2019;39(7):720-732. doi:10.1093/asj/sjy197Abdelmofeed AM, Salama RS.Different modalities of nasolabial flaps in nasal-defect reconstruction: clinical experience in 40 cases and review of literature.The Egyptian Journal of Surgery. 2021;40(4):1192. doi:10.4103/ejs.ejs_191_21Patel UA, Hernandez D, Shnayder Y, et al.Free flap reconstruction monitoring techniques and frequency in the era of restricted resident work hours.JAMA Otolaryngol Head Neck Surg. 2017;143(8):803-809. doi:10.1001/jamaoto.2017.0304Patel SA, Abdollahi H, Ridge JA, Chang EI, Lango MN, Topham NS.Asymptomatic deep peroneal vein thrombosis during free fibula flap harvest: a review of the literature, strategies for preoperative assessment, and an algorithm for reconstruction.Ann Plast Surg. 2016;76(4):468-71. doi:10.1097/SAP.0000000000000355Gassman AA, Yoon AP, Maxhimer JB, et al.Comparison of postoperative pain control in autologous abdominal free flap versus implant-based breast reconstructions.Plast Reconstr Surg. 2015;135(2):356-67. doi:10.1097/PRS.0000000000000989MacKay BJ, Dardano AN, Klapper AM, Parekh SG, Soliman MQ, Valerio IL.Multidisciplinary application of an external tissue expander device to improve patient outcomes: a critical review.Adv Wound Care. 2020;9(9):525-538. doi:10.1089/wound.2019.1112Additional ReadingTschoi M, Hoy FA, Granick MS.Skin Flaps. Clinics of Plastic Surgery; 2005; April; Volume 32(2), p261-273.Basic Principles of Skin Flaps; Fisher J., Georgaide GS, Georgaide NG, Riefkohl R, Barwick WJ; Textbook of Plastic, Maxillofacial, and Reconstructive Surgery. Volume 1, 2nd edition,1992, p 29-40.Interview with Board Certified Facial Plastic and Reconstructive Surgeon,Andrew Jacono, MD, New York, NY.Skin Cancer and Your Plastic Surgeon, Patient Information Sheet, American Society of Plastic Surgeons.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Andree C, Munder BI, Seidenstuecker K, et al.Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy.Med Sci Monit. 2012;18(12):CR716-20. doi:10.12659/msm.883598Chorath K, Go B, Shinn JR, et al.Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis.Oral Oncol. 2021;113:105117. doi:10.1016/j.oraloncology.2020.105117Swendseid BP, Roden DF, Vimawala S, Richa T, Sweeny L, Goldman RA, Luginbuhl A, Heffelfinger RN, Khanna S, Curry JM.Virtual surgical planning in subscapular system free flap reconstruction of midface defects.Oral Oncology. 2020; 101. doi: oi.org/10.1016Yellinek S, Krizzuk D, Moreno Djadou T, Lavy D, Wexner SD.Endorectal advancement flap for complex anal fistula: does flap configuration matter?Colorectal Dis. 2019;21(5):581-587. doi:10.1111/codi.14564Christopoulos G, Deraje V, Mbaidjol Z, Kannan RY.The “snail flap”: a rotation flap in scalp reconstruction.Plast Reconstr Surg Glob Open. 2020;8(1):e2599. doi:10.1097/GOX.0000000000002599Taş S.Superior-based transposition flap: a novel technique in rhinoplasty.Aesthet Surg J. 2019;39(7):720-732. doi:10.1093/asj/sjy197Abdelmofeed AM, Salama RS.Different modalities of nasolabial flaps in nasal-defect reconstruction: clinical experience in 40 cases and review of literature.The Egyptian Journal of Surgery. 2021;40(4):1192. doi:10.4103/ejs.ejs_191_21Patel UA, Hernandez D, Shnayder Y, et al.Free flap reconstruction monitoring techniques and frequency in the era of restricted resident work hours.JAMA Otolaryngol Head Neck Surg. 2017;143(8):803-809. doi:10.1001/jamaoto.2017.0304Patel SA, Abdollahi H, Ridge JA, Chang EI, Lango MN, Topham NS.Asymptomatic deep peroneal vein thrombosis during free fibula flap harvest: a review of the literature, strategies for preoperative assessment, and an algorithm for reconstruction.Ann Plast Surg. 2016;76(4):468-71. doi:10.1097/SAP.0000000000000355Gassman AA, Yoon AP, Maxhimer JB, et al.Comparison of postoperative pain control in autologous abdominal free flap versus implant-based breast reconstructions.Plast Reconstr Surg. 2015;135(2):356-67. doi:10.1097/PRS.0000000000000989MacKay BJ, Dardano AN, Klapper AM, Parekh SG, Soliman MQ, Valerio IL.Multidisciplinary application of an external tissue expander device to improve patient outcomes: a critical review.Adv Wound Care. 2020;9(9):525-538. doi:10.1089/wound.2019.1112
Andree C, Munder BI, Seidenstuecker K, et al.Skin-sparing mastectomy and immediate reconstruction with DIEP flap after breast-conserving therapy.Med Sci Monit. 2012;18(12):CR716-20. doi:10.12659/msm.883598
Chorath K, Go B, Shinn JR, et al.Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis.Oral Oncol. 2021;113:105117. doi:10.1016/j.oraloncology.2020.105117
Swendseid BP, Roden DF, Vimawala S, Richa T, Sweeny L, Goldman RA, Luginbuhl A, Heffelfinger RN, Khanna S, Curry JM.Virtual surgical planning in subscapular system free flap reconstruction of midface defects.Oral Oncology. 2020; 101. doi: oi.org/10.1016
Yellinek S, Krizzuk D, Moreno Djadou T, Lavy D, Wexner SD.Endorectal advancement flap for complex anal fistula: does flap configuration matter?Colorectal Dis. 2019;21(5):581-587. doi:10.1111/codi.14564
Christopoulos G, Deraje V, Mbaidjol Z, Kannan RY.The “snail flap”: a rotation flap in scalp reconstruction.Plast Reconstr Surg Glob Open. 2020;8(1):e2599. doi:10.1097/GOX.0000000000002599
Taş S.Superior-based transposition flap: a novel technique in rhinoplasty.Aesthet Surg J. 2019;39(7):720-732. doi:10.1093/asj/sjy197
Abdelmofeed AM, Salama RS.Different modalities of nasolabial flaps in nasal-defect reconstruction: clinical experience in 40 cases and review of literature.The Egyptian Journal of Surgery. 2021;40(4):1192. doi:10.4103/ejs.ejs_191_21
Patel UA, Hernandez D, Shnayder Y, et al.Free flap reconstruction monitoring techniques and frequency in the era of restricted resident work hours.JAMA Otolaryngol Head Neck Surg. 2017;143(8):803-809. doi:10.1001/jamaoto.2017.0304
Patel SA, Abdollahi H, Ridge JA, Chang EI, Lango MN, Topham NS.Asymptomatic deep peroneal vein thrombosis during free fibula flap harvest: a review of the literature, strategies for preoperative assessment, and an algorithm for reconstruction.Ann Plast Surg. 2016;76(4):468-71. doi:10.1097/SAP.0000000000000355
Gassman AA, Yoon AP, Maxhimer JB, et al.Comparison of postoperative pain control in autologous abdominal free flap versus implant-based breast reconstructions.Plast Reconstr Surg. 2015;135(2):356-67. doi:10.1097/PRS.0000000000000989
MacKay BJ, Dardano AN, Klapper AM, Parekh SG, Soliman MQ, Valerio IL.Multidisciplinary application of an external tissue expander device to improve patient outcomes: a critical review.Adv Wound Care. 2020;9(9):525-538. doi:10.1089/wound.2019.1112
Tschoi M, Hoy FA, Granick MS.Skin Flaps. Clinics of Plastic Surgery; 2005; April; Volume 32(2), p261-273.Basic Principles of Skin Flaps; Fisher J., Georgaide GS, Georgaide NG, Riefkohl R, Barwick WJ; Textbook of Plastic, Maxillofacial, and Reconstructive Surgery. Volume 1, 2nd edition,1992, p 29-40.Interview with Board Certified Facial Plastic and Reconstructive Surgeon,Andrew Jacono, MD, New York, NY.Skin Cancer and Your Plastic Surgeon, Patient Information Sheet, American Society of Plastic Surgeons.
Tschoi M, Hoy FA, Granick MS.Skin Flaps. Clinics of Plastic Surgery; 2005; April; Volume 32(2), p261-273.
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