A flap is a piece of living tissue moved to a new position while keeping its own blood supply. Local flaps borrow that tissue from skin lying immediately beside the wound. Because the neighbouring skin usually matches in colour, thickness and texture, the repair tends to blend better than a graft, and it brings its own circulation to a bed that may not support a graft at all.
These techniques are the everyday tools of reconstructive surgery. They close defects after skin cancer removal, release tight scars, resurface the face and hand, and cover small areas of exposed bone or tendon. The name of each flap describes how the skin is moved rather than where it comes from. Choosing between them depends on the shape of the defect, the looseness of the surrounding skin and where the final scar will sit.
Each design moves skin in a different direction, so the choice follows the shape of the defect and the direction in which nearby skin is slack.
Skin has natural creases and tension lines. A flap is designed so the final scar falls into a crease, along a hairline or at the border between two facial units, because a scar placed in the wrong direction stays visible even when it heals well.
Some flaps survive on the fine network within the skin itself, while others are raised on a named feeding vessel found with a handheld probe. Knowing which type is being used explains why some designs can be narrow and long and others cannot.
Fresh flap scars look raised and red for weeks before softening. Sun protection, massage once the wound is sound, and taping or silicone as advised all help. Final appearance is judged after many months rather than at the first dressing change.
A graft has no blood supply of its own and needs a healthy bed. Where the wound is very large, where the surrounding skin is tight or where the area must be watched for tumour return, a graft may be the safer or simpler choice.
Most local flaps settle uneventfully, but early recognition of circulation trouble makes a difference.
The same points come up whether the flap is planned for the face, the hand or the leg.
Ask your question →Cost depends on the size and site of the defect, whether local or general anaesthesia is used, theatre time and whether the procedure is done as a day case. A written estimate is given after examination, and reconstruction after cancer is often insurable.
Facial flaps are done routinely and the blood supply of the face is generous, which helps healing. Risks include bleeding, infection, partial flap loss and scar visibility. Smoking reduces circulation and is discouraged well before and after the operation.
Stitches usually stay for about a week on the face and longer elsewhere, with swelling and bruising settling over the following weeks. Light activity resumes quickly. Recovery can vary with the site, the size and your general healing.
A scar always remains, but a well designed flap places it in a crease or border so it draws less attention. Redness fades gradually and the contour evens out over months. Revision of a small irregularity is sometimes offered later.
It suits people whose defect is modest in size and who have healthy, reasonably slack skin next to it. Heavily irradiated skin, active infection or very large wounds may call for a different technique instead.
After tumour removal or injury, earlier closure generally gives a cleaner result and lowers infection risk. An open wound with exposed bone or tendon should not be left for long. Elective scar release can be planned at your convenience.
The defect or lesion is examined and measured, the surrounding skin is assessed for looseness, and the likely design is drawn and explained. Anaesthesia choice, dressing plan, expected scar position and risks are covered before the date is booked.
