Designing the Perfect Local Flap, Book Review, & Eyelid Reconstruction.

Also: The Sunday quiz, podcast teaser, & 3 recommended articles.
Designing the Perfect Local Flap, Book Review, & Eyelid Reconstruction.

In this week's edition

  1. ✍️ Letter from P'Fella
    How I Pick the Right Skin Flap
  2. 🤓 The Sunday Quiz
    How well do you know Bilobed Flaps?
  3. 🎙️ Behind the 'Fella
    Sneak peek from episode 04: Best plastic surgery resources.
  4. 🎓 theFellow's Corner
    This week's feature: Venous Flaps.
  5. 📚 Book Review
    "Local Flaps in Facial Reconstruction" by Shan R. Baker.
  6. 🔥 Articles of the Week
    Tips on nasal and eyelid reconstruction; 3 articles with 1 sentence summaries.
  7. 💕 Feedback
    Suggest ideas & give feedback!

A Letter from P'Fella

"How I Pick the Right Skin Flap"

👋
Hey everyone!

Let’s get real about choosing the right local skin flap—it’s all about understanding the skin you’re working with and making practical decisions on the fly.


👇

First, not all skin is the same. Take nasal alar skin, for example—it’s thick, firm, and doesn’t stretch much, unlike cheek skin, which is softer and more pliable. This difference matters big time. If I’m covering a defect on the nose, I’m probably not going to use the same flap I’d choose for the cheek. The goal is to pick a flap that matches the skin’s texture and mobility so it blends in naturally.

Now, location is key. On the face, it’s all about aesthetics. I often go for rotation or advancement flaps that follow natural lines. They’re reliable and give a nice, seamless finish. But if I’m dealing with something larger or in a tricky spot, like the nose, a bilobed flap can work wonders—it lets me move skin around without creating too much tension.

Image from Baker

Size and shape? Also super important. Small defects? A simple advancement flap usually does the trick. But for bigger or oddly shaped ones, I might opt for a transposition flap. It gives good coverage and helps spread out the tension, so everything heals up nicely.

So, here’s the takeaway: Know your skin—whether it’s thick, thin, mobile, or tight—and pick a flap that matches. Keep it simple but effective, and always aim for the best cosmetic result with the least tension. Trust your gut, but also let the skin guide your decision.

Lots of love,
P'Fella ❤️

The Sunday Quiz

How Well Do You Know Bilobed Flaps?

Are you ready to make it to the leaderboard?

Welcome to the next round of The Weekly Quiz.

Each edition of thePlasticsPaper includes a quiz question designed to challenge and engage our readers. Keep your wits about you and join in every week — the winner at the end of six rounds will earn you a $100 voucher.

Esser's Original Publication of Bilobed Flaps
Image from Esser's Original Publication of Bilobed Flaps in 1918

Behind the ‘Fella

Sneak Peek from Episode 04

🎧
Tune in Now: "Behind the Fella"

Tune into our podcast for exclusive team meetings where we uncover behind-the-scenes details of the platform and discuss hot topics in plastic surgery with our fellows.

In our upcoming episode, we explore the best plastic surgery resources for learning!

You can subscribe on Spotify & Apple.

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Let us know your thoughts on podcasts here 👇

the Fellows' Corner

This Week's Focus: Venous Flaps

In case you've missed out, here's a reminder to check out our fresh articles, clinical cases, and surgical techniques.

Read below for an overview of our article on Venous Flaps.

Venous Flaps

Physiology
The exact physiology of venous flaps is relatively unknown.

Classification
Thatte and Thatte is the standard classification for venous flaps. There are 3 types of venous flaps based on the number of veins & their function.

Evaluation
They do not have a high survival rate and are not used regularly due to this.

Read the Article

Book Review

"Local Flaps in Facial Reconstruction" by Shan R. Baker

Local Flaps in Facial Reconstruction"

Hey there! If you're into facial reconstructive surgery, "Local Flaps in Facial Reconstruction" by Shan R. Baker is a fantastic resource. The book is loaded with clear, high-quality images that show patients before and after surgery.

The design of the flaps is explained in a way that's easy to follow, making it super helpful for both beginners and experienced surgeons. It’s practical, informative, and visually impressive — a great addition to your medical library.

Articles of the Week

3 Interesting Articles with 1 Sentence Summaries

1️⃣
Nasal reconstruction insights on restoring both appearance and function (Menick, 2010)

Preoperative planning for nasal reconstruction: Staged procedures using forehead tissue and cartilage grafts to achieve optimal results.

2️⃣
Using the bilobed flap in nasal reconstruction for defects on the lower third of the nose (Zitelli, 1989)

Discover design improvements that minimize issues like tissue protrusions, enhancing the overall outcome of nasal reconstruction using the bilobed flap.

3️⃣
How to achieve a successful eyelid reconstruction (Alghoul et al., 2019)

Explore eyelid reconstruction techniques that ensure proper function, aesthetics, and blend with surrounding tissues, focusing on normal eyelid positioning, distinct margins, and sharp canthal angles.

Feedback

I hope you enjoyed it 😄


About the author
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