Workhorse Reconstruction: Transposition Flaps

Maggie Chow, an assistant professor at USC, discusses transposition flaps in dermatological surgery, defining them as flaps that involve lifting tissue from a reservoir to cover a primary defect, inevitably creating a secondary defect. Highlighting their versatility, Chow notes transposition flaps are effective for redirecting tension and can efficiently move tissue compared to other flap types. She explores several variations, such as the rhombic flap, introduced by Lindbergh, which is particularly suited for upper facial defects, and other modifications like the defermental and Webster variations, each designed to optimize cosmetic results and functional outcomes. The presentation emphasizes techniques for designing and executing these flaps, including specific angles and measurements to achieve successful transpositions while minimizing tension. Chow illustrates the flap techniques with clinical images and videos, demonstrating their application across various anatomical regions, including the nose, cheeks, and ears. She concludes by affirming the transposition flap's role as an essential tool in dermatologic surgery, offering good cosmetic results when executed correctly.