A rhomboid flap turns the wound into a diamond shape and closes it with a matching diamond of skin taken from alongside. Because four different versions of the design are possible, the surgeon can choose whichever one closes most comfortably.
A rhomboid flap, sometimes called a Limberg flap, is a geometric version of a transposition flap. The defect is trimmed into a diamond with equal sides, and a matching diamond of skin beside it is raised and swung across. Four possible flaps surround any diamond, so the one whose donor area closes most easily is chosen.
Most local flaps are drawn by judgement. The rhomboid design is different, because it follows a set geometry that works out the same way every time. The wound is first shaped into a diamond with equal sides and two narrow corners. From one of those corners, a line is drawn outward and then turned, marking out a second diamond of exactly the same size beside the defect.
That second diamond is the flap. It is raised, swung across into the wound and stitched in place, while the space it leaves behind is closed directly. Since four such flaps can be drawn around any diamond, the surgeon has real choice. Pinching the skin in each direction shows which donor area will close most kindly, and that decides the version used.
The result is a closure with predictable tension and an angled scar pattern, which the eye finds harder to follow than a long straight line. The trade off is honest enough. Turning an irregular wound into a neat diamond means sacrificing a small amount of healthy skin, so the design is chosen where that price is worth paying.
This design suits small to moderate defects on areas where the skin has some give, and where a slightly angular scar pattern is acceptable.
The wound is trimmed into a diamond with equal sides. Only the minimum of healthy skin is taken, and the shape is oriented so the eventual scars follow natural creases where they can.
The surgeon then pinches the skin in each of the four possible directions. Whichever donor area closes most easily with least pull decides which version of the flap is drawn.
A matching diamond is marked beside the defect, using the sides of the original shape as a guide. Accuracy here is what keeps tension even once everything is moved.
The flap is lifted with the layer beneath it, keeping the base attached, and swung into the defect. It is inset with deep stitches first, then the surface is closed.
Finally the space left behind is closed directly, which is where most of the tension sits. A light dressing supports both areas until the first review.
Bruising and swelling are usual around the angled lines. The area is kept still, and simple pain relief is generally enough.
Stitches are removed at a time suited to the site. The flap can feel firm, and the angled scars look pink and raised at this stage.
Scars begin to soften and flatten. Normal activity resumes, while anything that stretches the repair is still avoided.
The angled pattern fades and becomes harder to see. Any small fold at a corner can be reviewed once the tissue has settled.
Closure is usually neat, with tissue that matches the area in colour and thickness. The scars form an angled pattern that is visible for months before it pales, and one limb of that pattern often sits across a crease. Firmness within the flap is common early and softens with time. A small fold at a corner can persist and may be trimmed later if it stays noticeable once swelling has gone.
The design is dependable, yet the flap still relies on blood flow through its base and the donor closure carries most of the tension.
Both the transposed diamond and the line where it came from need protecting. Tension across those lines is the main thing to avoid at home.
A small amount is indeed removed, and that is the trade for even tension and a closure whose behaviour is predictable.
Angled lines break up the light and are often harder to follow than one long straight scar across the same area.
Four options exist, but only some have loose enough skin. The direction is chosen by testing the tissue, not by preference.
Early firmness is scar tissue maturing. Colour change at the far corner is the sign that needs urgent review, not firmness alone.
At Elegance Clinic in Surat, the four possible designs are tested on the skin before anything is cut, so the closure follows the tissue rather than a preference.
Technique pages do not carry their own price, because the cost depends on the treatment the technique is used within. The same flap may close a small cheek defect or form one part of a larger reconstruction.
A written estimate covering surgery, anaesthesia, dressings and planned reviews is issued before admission. For bands, please see the relevant treatment page or the costs section.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →The technique carries no separate price, because it belongs inside a wider treatment. Cost depends on the defect being closed, the anaesthetic used and the reviews afterwards. A written estimate is provided before the surgery date is fixed.
Most are day case repairs under local anaesthetic. Bleeding beneath the flap, infection and loss of the far corner are the recognised concerns, and an early review is arranged so any colour change in the tissue is picked up quickly.
Shaping the wound into a diamond is what makes the geometry work, so tension is shared evenly and the flap fits exactly. The amount taken is small, and it is weighed against the benefit of a predictable closure.
Stitches usually come out within a fortnight depending on the site, and light activity often resumes within days. Scars stay pink and firm for months before they settle, so recovery can vary from person to person.
It is visible early and fades over many months. Because the lines meet at angles, the eye follows them less readily than a long straight scar, and one limb of the pattern is usually placed in a crease.
Very large defects, wounds where trimming to a diamond would sacrifice something important such as the lip margin, and areas where none of the four donor directions has enough loose skin to close comfortably.
The defect is measured, the skin is pinched in each direction to test looseness, and the chosen design is drawn on the surface. Smoking, medicines and general health are reviewed, then a written estimate is issued.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
