Arch Plast Surg.  2018 Jul;45(4):298-303. 10.5999/aps.2017.01543.

Anatomic basis for flap thinning

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Hanyang University Medical Center, Hanyang University College of Medicine, Seoul, Korea.
  • 2Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul, Korea. hchang@snu.ac.kr
  • 3Department of Anatomy, Keio University College of Medicine, Tokyo, Japan.

Abstract

Flap thinning is a procedure for making a thick flap thinner. This procedure does more than simply fill in the defected area, and it is better for reconstructing the area both functionally and aesthetically. However, because flap thinning is a rather blind procedure, it may have harmful effects on flap vascularity. Therefore, the vasculature of a flap must be understood before performing flap thinning. This paper analyzes the basic anatomy underlying flap thinning based on the previous anatomic study that categorized flaps into 6 types by their vascular structures. This paper also reviews specific studies of frequently practiced flap procedures (deep inferior epigastric artery perforator flap, thoracodorsal artery perforator flap, and anterolateral thigh flap) and presents important precautions for flap thinning procedures. Finally, this paper briefly examines the axiality of the subdermal plexus, which needs to be taken into account when performing flap thinning.

Keyword

Flap thinning; Flap anatomy; Thin flap

MeSH Terms

Arteries
Epigastric Arteries
Perforator Flap
Thigh
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