Skin lesions on the head and neck will often need to be surgically removed. When the lesions are small, the skin edges can easily be closed at the time of surgery. This technique, called primary closure, is the ideal situation because it closes the wound without excessive stress or deformity to the surrounding tissues.
Sometimes, a skin defect is larger, preventing primary closure of the skin edges. This is more likely to occur with skin cancers, where a margin of healthy tissue needs to be removed with the lesion. For these cases, the surgeon will often perform a local reconstructive skin flap. The principle is to rotate or advance some healthy skin and soft tissue from an adjacent area into the wound defect, while providing an optimal cosmetic result.
Local reconstructive flaps are most often obtained from the skin and soft tissue that is close to the wound defect. Usually, the flaps are designed so that the scar is hidden in a natural skin crease. Sometimes local flaps are done in conjunction with other procedures such as skin grafting. See pre-operative and post-operative photos below after removing a skin cancer from the nose and a rhomboid flap closure.