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About the procedure Local Flap Reconstruction

Our Philosophy on Local Flap Reconstruction

At AR Plastic Surgery, local flap reconstruction is used to close wounds in areas where direct closure is not suitable due to tension or limited skin availability. This technique involves using nearby skin and tissue to cover a surgical or traumatic defect while keeping the tissue connected to its original blood supply. Local flaps are commonly used in areas such as the face, scalp, ears, and lower limbs.

The surgeons who operate at AR Plastic Surgery assess each wound individually and consider the size, depth, and location before recommending a local flap. This method allows the use of skin that closely matches the surrounding area in colour, texture, and thickness. It is often preferred when the goal is to preserve nearby structures and support both function and appearance.

Our approach prioritises careful planning and patient education. We explain how the flap will be moved, how the wound will be closed, and what to expect during healing. All surgical options are discussed in detail during the consultation so that patients can make informed decisions about their care.

Understanding Local Flap Reconstruction

Local flap reconstruction involves lifting a section of skin and underlying tissue from an area close to the wound and repositioning it to cover the defect. The tissue remains attached to its original blood supply, which helps promote healing and supports tissue survival. This technique differs from skin grafts, which involve taking skin from a distant area and reattaching it without a direct blood supply.

Flaps may be rotated, moved forward, or repositioned from nearby areas, depending on the size and shape of the wound and the available surrounding skin. Each flap is planned to follow the natural movement of the skin and to avoid important areas such as the eyes, nose, or mouth. This approach helps protect function and lowers the risk of tension during healing.

Local flaps are especially useful in areas where preserving facial features, protecting exposed tissue, or reducing scar tension is important. They are commonly used in reconstructive procedures following skin cancer removal, trauma, or previous surgery. At AR Plastic Surgery, we match the repair technique to each patient’s specific needs and surgical goals.

Types of Local Flap Techniques

There are several types of local flap designs. Each has specific advantages depending on the wound and location. These techniques are explained during the consultation to help patients understand the planned approach.

  • Advancement Flap: This flap moves nearby skin in a straight line to cover the wound. It is often used when the surrounding skin has enough flexibility to allow forward movement without creating excessive tension. Common areas for this technique include the forehead, cheeks, and limbs.
  • Rotation Flap: This flap is curved and rotated into place. It is useful when the wound is near a tight or curved area, such as the scalp or side of the face. The flap follows the natural skin lines, which can help with healing and scar placement.
  • Transposition Flap: This flap is taken from nearby skin and moved over healthy tissue to cover the wound. It is useful when the wound is in a spot where nearby skin cannot be moved straight into place. This method is often used in areas like the nose or cheek.

 

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What to Expect on the Day of the Procedure

On the day of surgery, patients are welcomed to the surgical facility and guided through the final preparation steps. The surgical plan is reviewed, the flap design is marked, and the type of anaesthesia—local or general—is confirmed. Patients are encouraged to ask any final questions before surgery begins.

In the operating room, the wound is cleaned, and the local flap is carefully raised and moved into place. The donor site (where the flap came from) is also closed, often with stitches. The flap remains connected to its blood supply to help support healing and reduce complications.

After the procedure, dressings are applied, and patients are given instructions for home care. Depending on the location and complexity of the repair, some patients may go home the same day, while others may need closer monitoring. The surgical team provides contact information and sets a follow-up schedule before discharge.

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Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors, including the individual’s genetics, diet and exercise. Some images may have the patient’s tattoos, jewellery or other identifiable items blurred to protect patient identities.

Aftercare and Recovery

Recovery depends on the location of the flap, the size of the repair, and the patient’s general health. Some swelling, bruising, or tightness around the flap area is expected. Patients are advised to rest, avoid excessive movement in the area, and follow all wound care instructions.

Post-operative care includes keeping the wound clean, protecting the area from sun exposure, and avoiding activities that could stretch the flap. Instructions are given for dressing changes and bathing. In some cases, temporary numbness or firmness around the flap may occur, but usually settles over time.

Follow-up appointments are arranged to monitor healing and remove stitches if used. If the flap heals well, no further procedures are needed. However, in some cases, further revision may be discussed if there is bulkiness, scar concern, or flap contour changes over time.

Potential Risks

As with all surgical procedures, local flap reconstruction involves some risks. These risks are discussed with the patient before the operation. Potential risks include:

  • Infection
  • Bleeding
  • Haematoma
  • Wound separation
  • Delayed healing
  • Flap swelling
  • Poor circulation
  • Scarring
  • Contour irregularity
  • Numbness
  • Changes in skin sensation
  • Reaction to anaesthesia

Patients receive both written and verbal information on how to recognise signs of possible complications. A phone number is provided if they need advice or support once they are home. Most concerns can be addressed during follow-up visits or managed early if identified promptly.

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