Videos available online INTRODUCTION The principle of Z-plasty is one of the most versatile concepts in reconstructive surgery. The dynamics of tissue movement that occur with Z-plasty are particularly suited for certain types of scar revision. A clear understanding of…
Videos available online INTRODUCTION Median forehead flaps were first described in an Indian medical treatise, the Sushruta Samita, in approximately 700 BCE. The operation was performed by members of a caste of potters known as the Koomas . The need…
Videos available online INTRODUCTION The melolabial crease delineates the cheek from the caudal nose and from the upper and lower lips. It is created by the insertion of the superficial muscular aponeurotic system (SMAS) into the skin at the junction…
Videos available online INTRODUCTION Ever since the advent of Mohs’ micrographic surgery for the treatment of cutaneous malignant neoplasms, complex surgical defects of the head and neck have become increasingly challenging to repair with an acceptable functional and aesthetic result.…
Videos available online INTRODUCTION The original design of the bilobe flap is attributed to Esser, who described its use in 1918 for reconstruction of nasal tip defects. Ziminy and others expanded the use of the flap to reconstruct defects on…
INTRODUCTION Most local cutaneous flaps used in the head and neck have some component of advancement during movement of the flap to the recipient site. An example is the paramedian interpolated forehead flap. Although this flap is classified as pivotal,…
Videos available online INTRODUCTION In contrast to rotation flaps, which have a curvilinear configuration, transposition flaps have a linear configuration. Both are pivotal flaps moving about a pivotal point. Both flaps develop standing cutaneous deformities (SCDs) at their bases and…
INTRODUCTION Rotation flaps are pivotal flaps with a curvilinear configuration. By necessity they must be designed immediately adjacent to the defect. Thus a border of the defect becomes the advancing border of the skin flap. Although useful in many clinical…
Videos available online INTRODUCTION The author defines a local cutaneous flap as an area of skin and subcutaneous tissue with a direct vascular supply that is transferred from its in situ position to a site located immediately adjacent to or…
PREPARATION OF THE PATIENT Surgical restoration of the face may require a multistage procedure with a potentially protracted healing period before the final aesthetic outcome is evident. The initial reconstructive procedure is usually the most influential in predicting the aesthetic…