eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Rhombic Flaps: Follow-up

Author: Anthony P Sclafani, MD, Director of Facial Plastic Surgery, The New York Eye and Ear Infirmary; Professor of Otolaryngology, New York Medical College
Coauthor(s): Michael Fozo, MD, Staff Physician, Department of Otolaryngology, New York Eye and Ear Infirmary, New York Medical College
Contributor Information and Disclosures

Updated: Feb 12, 2009

Outcome and Prognosis

All rhomboid flaps are closed under some degree of tension, and this tension is characteristically unevenly distributed along the flap's length.

Areas of maximal tension are subject to preferential widening and depression along the line of tension. Pin-cushioning or trap-door deformities may develop and may be related to inadequate incision of wound edges, incomplete undermining, or postoperative scar thickening.

A thickened scar may be managed with intralesional corticosteroid injections (triamcinolone acetate 10 mg/mL) in the early postoperative period, or by secondary revision surgery. A poorly planned flap will distort anatomical landmarks and leave a poorly oriented scar.

Dermabrasion is routinely offered to all patients undergoing facial transposition flap surgery. The authors believe it offers subtle, but definite, improvement even to the best scars and can be performed simply and quickly in the office. Ideally, dermabrasion can be performed 6 weeks after flap transposition but can also be offered to patients at any time after this interval.

 


More on Rhombic Flaps

Overview: Rhombic Flaps
Workup: Rhombic Flaps
Treatment: Rhombic Flaps
Follow-up: Rhombic Flaps
Multimedia: Rhombic Flaps
References
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References

  1. Webster RC, Davidson TM, Smith RC. The thirty degree transposition flap. Laryngoscope. Jan 1978;88(1 Pt 1):85-94. [Medline].

  2. Becker FF. Rhomboid flap in facial reconstruction. New concept of tension lines. Arch Otolaryngol. Oct 1979;105(10):569-73. [Medline].

  3. Borges AF. The rhombic flap. Plast Reconstr Surg. Apr 1981;67(4):458-66. [Medline].

  4. Bray DA. Clinical applications of the rhomboid flap. Arch Otolaryngol. Jan 1983;109(1):37-42. [Medline].

  5. Calhoun KH, Seikaly H, Quinn FB. Teaching paradigm for decision making in facial skin defect reconstructions. Arch Otolaryngol Head Neck Surg. Jan 1998;124(1):60-6. [Medline].

  6. Connor CD, Fosko SW. Anatomy and physiology of local skin flaps. Facial Plast Surg Clin North Am. 1996;4:447-454.

  7. Larrabee WF Jr, Trachy R, Sutton D, Cox K. Rhomboid flap dynamics. Arch Otolaryngol. Dec 1981;107(12):755-7. [Medline].

  8. Ling EH, Wang TD. Local flaps in forehead and temporal reconstruction. Facial Plast Surg Clin North Am. 1996;4:469.

  9. Lober CW, Mendelsohn HE, Fenske NA. Rhomboid transposition flaps. Aesthetic Plast Surg. 1985;9(2):121-4. [Medline].

  10. Stegman SJ. Flexible rhombic flap. Plast Reconstr Surg. Mar 1987;79(3):497-9. [Medline].

  11. Townend J. A template for the planning of rhombic skin flaps. Plast Reconstr Surg. Oct 1993;92(5):968-71. [Medline].

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Further Reading

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Keywords

rhombic flaps, rhomboid flap, skin flap, skin flaps, rhombus flap, transposition flap, rhombus-shaped defect, local flap, full-thickness local flap, random flap, Limberg flap, Dufourmentel flap, Webster flap, M-plasty

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Contributor Information and Disclosures

Author

Anthony P Sclafani, MD, Director of Facial Plastic Surgery, The New York Eye and Ear Infirmary; Professor of Otolaryngology, New York Medical College
Anthony P Sclafani, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons
Disclosure: Medicis None Speaking and teaching; Contura None Board membership; Contura Grant/research funds Independent contractor; Cascade Medical Grant/research funds Independent contractor; Cascade Medical None Board membership

Coauthor(s)

Michael Fozo, MD, Staff Physician, Department of Otolaryngology, New York Eye and Ear Infirmary, New York Medical College
Michael Fozo, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, Medical Society of the State of New York, and Sigma Xi
Disclosure: Nothing to disclose.

Medical Editor

Gregory Branham, MD, Vice-Chair, Director, Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Saint Louis University School of Medicine
Gregory Branham, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David W Stepnick, MD, Associate Professor, Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland Case Medical Center
David W Stepnick, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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