Refinements of the Subcutaneous Pedicle Flap for Closure of Forehead and Scalp Defects

Upper Lip Repair—The Subcutaneous Island Pedicle Flap

“…The subcutaneous island pedicle flap was first described by Barron and Emmett in 1965 1 . There are numerous reports attesting to the success of this flap in facial reconstruction 2–6 . There are, however, few reports of its use in lateral upper lip reconstruction.…”

Local Flaps, Including Pedicled Perforator Flaps

“…26,27 Random pattern flaps can be classified according to their geometric configuration (rhombic, bilobed, V-Y, Z-plasties, or W-plasties) and by their method of transfer (rotation, advancement, interpolation, transposition, and island flaps). 28,29 …”

Flap Dynamics

“…If the fat is not sufficiently thick to support a deep central pedicle, a rotation type lateral pedicle is used. This is appropriate for defects of the forehead 52,53 and medial nose. On the extremities and trunk, the vascularity of the fat is less than that of the face.…”

“…A central (deep) pedicle requires a thick pad of fat underlying the flap, as may be found on the cheek 49–51 . If the panniculus is sparse, as on the forehead and scalp, only lateral pedicles are possible 52,53 . Often, situations arise when either centrally or laterally based pedicles can be used and the issue becomes a matter of preference.…”