title: Introduction to flap movement: reconstruction of five similar nasal defects using different flaps.
abstract: BACKGROUND
  There are several options for closure of a given surgical defect after tumor extirpation is confirmed. Flap reconstruction is one of these options.
  
  
  OBJECTIVE
  The purpose of this article is to introduce the three basic types of flap movement: advancement, rotation, and transposition.
  
  
  METHODS
  Five similar defects located on the nasal sidewall were repaired, each using a different flap design.
  
  
  RESULTS
  The optimal flap design for a given defect on a particular patient is based on the answers to a series of questions: Where is the available tissue reservoir? How can tissue be mobilized from the reservoir to cover the defect? How do the resulting tension vectors affect critical structures? Where are the final incision lines?
  
  
  CONCLUSIONS
  Many factors must be evaluated before determining a method of reconstruction. Flap reconstruction requires a thorough understanding of anatomy and tissue movement.
authors.affiliation: Department of Dermatology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: Elbert H
authors.initials: EH
authors.lastname: Chen
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Johnson
authors.forename: Désirée
authors.initials: D
authors.lastname: Ratner
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D009666:Nose / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012225:Rhinoplasty / Q000379:methods; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps