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CC BY-NC 4.0 · Arch Plast Surg 2018; 45(04): 319-324
DOI: 10.5999/aps.2018.00542
Topic: how to obtain thin flap

Secondary contouring of flaps

Tae Gon Kim 
Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea
,
Man Ki Choi
Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea
› Author AffiliationsThis work was supported by the 2018 Yeungnam University Research Grant.
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Perforator flaps are becoming increasingly common, and as primary thinning techniques are being developed, the need for secondary contouring of flaps is decreasing. However, many reconstructive flap procedures still incorporate secondary debulking to improve the functional and aesthetic outcomes. Direct excision, liposuction, tissue shaving with an arthroscopic cartilage shaver, and skin grafting are the four major methods used for secondary debulking. Direct excision is primarily applied in flaps where the skin is redundant, even though the volume is not excessive. However, due to the limited range of excision, performing a staged excision is recommended. Liposuction can reduce the amount of subcutaneous tissue of the flap and protect the vascular pedicles. However, the main drawback of this method is its limited ability to remove fibrotic tissues, for which the use of a shaver may be more convenient. The main drawback of using a shaver is that it is difficult to simultaneously remove excess skin. Skin grafting enables the removal of sufficient excess tissue to recover the contour of the normal limb and to improve the color match, facilitating excellent aesthetic results.

Keywords

Surgical flaps - Perforator flap - Lipectomy - Reoperation - Contouring


Publication History

Received: 26 May 2018

Accepted: 05 July 2018

Article published online:
03 April 2022

© 2018. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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