Several techniques for creating flaps are used in plastic surgery.
Name | Tissue Type | Complexity | Use |
---|---|---|---|
Abbe flap | Cutaneous | Transposition | Full-thickness lip defects |
Anterolateral thigh flap (ALT flap) | Musculocutaneous | Free flap/Interpolation | Abdominal wall [1] / Open tibial fractures / Esophageal reconstruction [2] |
Becker flap | Fasciocutaneous | Interpolation | Hand reconstruction |
Deep inferior epigastric perforator (DIEP) flap [3] | Cutaneous | Free flap | Free flap breast reconstruction |
Dufourmental flap | Cutaneous | Rotation/Transposition | |
Estlander flap | Cutaneous | Transposition | Labial commissure of mouth defects |
Fibular flap | Osteocutaneous | Free flap | Mandible reconstruction |
Gastrocnemius flap | Muscle | Interpolation | Open tibial fractures |
Hatchett design flap | Cutaneous | Advancement | Forehead excisions/defects |
Inferior gluteal artery perforator (IGAP) flap [4] | Cutaneous | Free flap | Free flap breast reconstruction |
Karapandzic flap | Cutaneous | Rotation | Full-thickness lip defects |
Latissimus flap | Musculocutaneous | Interpolation | Breast reconstruction |
McGregor flap | Cutaneous | Rotation | Full-thickness lip defects |
Posterior interosseous artery (PIA) flap | Fasciocutaneous | Interpolation | Hand reconstruction |
Radial forearm/Chinese flap | Fasciocutaneous | Interpolation | Hand reconstruction |
Reverse sural artery flap | Muscle | Interpolation | Calcaneal pressure sores |
Rhombic/Limberg flap | Cutaneous | Rotation/Transposition | |
Scapular flap | Osteocutaneous | Free flap | Mandible reconstruction |
Shutter design flap | Cutaneous | Advancement | Forehead excisions |
Superficial inferior epigastric artery (SIEA) flap | Cutaneous | Free flap | Free flap breast reconstruction |
Superior gluteal artery perforator (SGAP) flap | Cutaneous | Free flap | Free flap breast reconstruction |
Transverse rectus abdominis myocutaneous (TRAM) flap [5] | Musculocutaneous | Free flap | Free flap breast reconstruction |
Transverse upper gracillis (TUG) flap | Musculocutaneous | Free flap | Free flap breast reconstruction |
V-Y advancement flap | Cutaneous | Advancement | Rhinoplasty |
Worthen forehead flap | Cutaneous | Rotation | Forehead excisions/defects |
Z-plasty | Cutaneous | Transposition | scars |
Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both with the goal of reconstructing a natural-looking breast. This process often also includes the rebuilding of the nipple and areola, known as nipple-areola complex (NAC) reconstruction, as one of the final stages.
Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.
A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. The term is also used for the normal development of the intestinal tract, referring to the retraction of the intestine from the extra-embryonal navel coelom into the abdomen in the healthy embryo at about 7½ weeks.
Rhinoplasty, commonly called nose job, medically called nasal reconstruction, is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.
An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus for clot formation (thrombosis) and embolization. As an aneurysm increases in size, the risk of rupture, which leads to uncontrolled bleeding, increases. Although they may occur in any blood vessel, particularly lethal examples include aneurysms of the circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can arise in the heart itself following a heart attack, including both ventricular and atrial septal aneurysms. There are congenital atrial septal aneurysms, a rare heart defect.
Phalloplasty is the construction or reconstruction of a penis or the artificial modification of the penis by surgery. The term is also occasionally used to refer to penis enlargement.
Gender-affirming surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning.
Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplasty is needed following the treatment or removal of malignant growths or abscesses to restore a normal vaginal structure and function. Surgery to the vagina is done to correct congenital defects to the vagina, urethra and rectum. It may correct protrusion of the urinary bladder into the vagina (cystocele) and protrusion of the rectum (rectocele) into the vagina. Often, a vaginoplasty is performed to repair the vagina and its attached structures due to trauma or injury.
An aortic aneurysm is an enlargement (dilatation) of the aorta to greater than 1.5 times normal size. Typically, there are no symptoms except when the aneurysm dissects or ruptures, which causes sudden, severe pain in the abdomen and lower back.
Abdominal aortic aneurysm (AAA) is a localized enlargement of the abdominal aorta such that the diameter is greater than 3 cm or more than 50% larger than normal. An AAA usually causes no symptoms, except during rupture. Occasionally, abdominal, back, or leg pain may occur. Large aneurysms can sometimes be felt by pushing on the abdomen. Rupture may result in pain in the abdomen or back, low blood pressure, or loss of consciousness, and often results in death.
The internal thoracic artery (ITA), also known as the internal mammary artery, is an artery that supplies the anterior chest wall and the breasts. It is a paired artery, with one running along each side of the sternum, to continue after its bifurcation as the superior epigastric and musculophrenic arteries.
An abdominal pregnancy is a rare type of ectopic pregnancy where the embryo or fetus is growing and developing outside the uterus, in the abdomen, and not in a fallopian tube, an ovary, or the broad ligament.
In human anatomy, the superior epigastric artery is a terminal branch of the internal thoracic artery that provides arterial supply to the abdominal wall, and upper rectus abdominis muscle. It enters the rectus sheath to descend upon the inner surface of the rectus abdominis muscle. It ends by anastomosing with the inferior epigastric artery.
Vaginectomy is a surgery to remove all or part of the vagina. It is one form of treatment for individuals with vaginal cancer or rectal cancer that is used to remove tissue with cancerous cells. It can also be used in gender-affirming surgery. Some people born with a vagina who identify as trans men or as nonbinary may choose vaginectomy in conjunction with other surgeries to make the clitoris more penis-like (metoidioplasty), construct of a full-size penis (phalloplasty), or create a relatively smooth, featureless genital area.
A DIEP flap is type of breast reconstruction where blood vessels, fat, and skin from the lower belly are relocated to the chest to rebuild breasts after mastectomy. DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen. This is a type of autologous reconstruction, meaning one's own tissue is used.
Abdominal fascia refers to the various types of fascia found in the abdominal region. Fascia is a sheet of connective tissue that is found beneath the skin that attaches, stabilizes, encloses, and separates muscles and other internal organs. Everyone has fascia, as it is part of how the human body is composed. Fascia is organized by layer, and can also be classified by location or function in the body. While abdominal fascia is quite a simple part of how the human body is made up, there are other implications and involvements that abdominal fascia is a part of.
Flap surgery is a technique in plastic and reconstructive surgery where tissue with an intact blood supply is lifted from a donor site and moved to a recipient site. Flaps are distinct from grafts, which do not have an intact blood supply and relies on the growth of new blood vessels. Flaps are done to fill a defect such as a wound resulting from injury or surgery when the remaining tissue is unable to support a graft, or to rebuild more complex anatomic structures like breasts or jaws.
Perforator flap surgery is a technique used in reconstructive surgery where skin and/or subcutaneous fat are removed from a distant or adjacent part of the body to reconstruct the excised part. The vessels that supply blood to the flap are isolated perforator(s) derived from a deep vascular system through the underlying muscle or intermuscular septa. Some perforators can have a mixed septal and intramuscular course before reaching the skin. The name of the particular flap is retrieved from its perforator and not from the underlying muscle. If there is a potential to harvest multiple perforator flaps from one vessel, the name of each flap is based on its anatomical region or muscle. For example, a perforator that only traverses through the septum to supply the underlying skin is called a septal perforator. Whereas a flap that is vascularised by a perforator traversing only through muscle to supply the underlying skin is called a muscle perforator. According to the distinct origin of their vascular supply, perforators can be classified into direct and indirect perforators. Direct perforators only pierce the deep fascia, they don't traverse any other structural tissue. Indirect perforators first run through other structures before piercing the deep fascia.
Free-flap breast reconstruction is a type of autologous-tissue breast reconstruction applied after mastectomy for breast cancer, without the emplacement of a breast implant prosthesis. As a type of plastic surgery, the free-flap procedure for breast reconstruction employs tissues, harvested from another part of the woman's body, to create a vascularised flap, which is equipped with its own blood vessels. Breast-reconstruction mammoplasty can sometimes be realised with the application of a pedicled flap of tissue that has been harvested from the latissimus dorsi muscle, which is the broadest muscle of the back, to which the pedicle (“foot”) of the tissue flap remains attached until it successfully grafts to the recipient site, the mastectomy wound. Moreover, if the volume of breast-tissue excised was of relatively small mass, breast augmentation procedures, such as autologous-fat grafting, also can be applied to reconstruct the breast lost to mastectomy.
Frank Hölzle is a German surgeon. He is a professor of oral and maxillofacial surgery at the RWTH Aachen University. He is chairman and head of the Department of Oral and Maxillofacial Surgery. Hölzle is known for his work in the fields of plastic facial reconstruction with a focus on micro surgery. He is also specialised for the treatment of tumor diseases in the head and neck region, and of malformations like cleft lip and palate.