title: Concepts of sliding and lifting tissue movement in flap reconstruction.
abstract: BACKGROUND
  The optimal design of a skin flap requires an understanding of the concepts of tissue movement.
  
  
  OBJECTIVE
  The purpose of this manuscript was to demonstrate concepts of sliding and lifting tissue movement for flap reconstruction.
  
  
  METHODS
  Six similar defects located in the forehead-temple-eyebrow region were repaired using a different skin flap.
  
  
  RESULTS
  The specific flap design for a given defect is based on the answer to three predictable events that result from tissue transfer: Where is the tension? Where are the final incision lines? Where is the redundant tissue?
  
  
  CONCLUSIONS
  A mental exercise assessing all available reconstruction options should be performed for each individual patient and defect. Both patient and defect considerations need to be assessed. A thorough understanding of both anatomy and tissue movement is necessary for optimal skin flap reconstruction.
authors.affiliation: Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0314, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Johnson
authors.forename: N
authors.initials: N
authors.lastname: Swanson
authors.forename: S R
authors.initials: SR
authors.lastname: Baker
mesh_terms: D000328:Adult; D000368:Aged; D005153:Facial Neoplasms / Q000601:surgery*; D005260:Female; D005546:Forehead / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000534:rehabilitation; D019651:Plastic Surgery Procedures / Q000379:methods; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps