Flap techniques


  • anterior lamellae can be reconstructed with less contracture during healing
  • a viable vascular supply at the base of the flap increased the viability of the tissue compared with skin graft
Three types of flap:
  • advancement flaps (tissue moves directly forward into a defect)
  • rotation 
  • transposition flaps (in rotation flap, the flaps rotate about a pivot point whereras in transposition flap the flap is moved lateratlly to cover a defect; in practice both techniques are combined to a certain degrees. Therefore a flap tends to be called by its name rather than the principle which predominates for example V-Y plasty or O-Z plasty)
Note: length of a flap should be less than three times the width of the base to allow vascular supply at the base

Useful flap techniques:

Rounded defect in the lower lid.

An O-Z plasty (a double rotational flap)
is useful for closing the defect with minimal 

Defect in the lower/upper lids can be
corrected with advancement flaps. The
two triangle at the base reduces dog
ear deformity.

The dog ears at the base of the flaps 
can be corrected using the Burrow's 
triangle to allow smooth closure.

Lesion in the medial canthus

V-Y plasty brings the tissue down 
to cover the defects

Lesion in the lower lid involving the 
lateral canthus

Transposition flap using the upper lid
skin to cover the lower lid defect. The
reverse is not recommended as closure of 
the lower lid defect can lead to ectropion.

Return to partial-thickness defects