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Facial Flaps


Authors: Liv Schöllhammer, MD, Frederik Gulmark Hansen, med.stud. and Magnus Balslev Avnstorp, MD

This chapter describes what you should know when preparing, designing and performing facial reconstructive surgery usinglocal skin flaps. 
We present basic knowledge on flap surgery below followed by some specific facial flaps and when to use them. 


  • Local skin flap: A flap based on skin tissue adjacent to the excision defect. 
    The predominant movement indicates which skin flap is used – i.e., rotation, advancement, transposition, de-epithelized turnover flap.
  • Donor site: The site from where the flap is harvested.
  • Primary defect/Recipient site: The wound or tissue defect to be closed with the flap.
  • Secondary defect: Defect at the donor site of the flap, created when the flap is transferred to the primary defect.


The word flap derives from the Dutch word flappe, which is something that is fastened in one side and hanging loose on the other side

The first documented use of local flaps, as we know it, dates back ancient India in Sushruta Samhita, which is an ancient Sanskrit text on medicine and surgery. In these chapters a nasal reconstruction using a local forehead/frontal flap is described. (1) With the increased understanding of blood supply, dozens of facial local flaps have been developed since then.


Flaps are used to close skin defects which most often are the result of either a trauma or excision of tissue with suspicion of malignancy.

Go to the chapter Excision of Facial Tumors to read more.

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