Reconstruction After BCC Surgery – Local Flap

Learn how local flap reconstruction is used to repair skin after BCC removal, offering a natural and effective way to restore nearby tissue.

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What is a local skin flap?

In surgery, a skin flap is a term used to describe a piece of skin that is lifted and moved from one place to another.

Crucially, part of the skin remains attached to where it came from, keeping blood flowing in and out of the skin to keep it alive.

Keeping a source of blood flow in and out of the skin is what makes it ‘a flap’.

When the skin is moved to a part of the body directly next to it (eg a piece of cheek skin is turned to fill a cheek wound), this is termed a ‘local’ flap.

Some fat and/or muscle is often taken with the skin, to help fill the wound and improve the blood flow in the flap.

Reconstruction after BCC surgery - local flap

Basal cell carcinoma surgery can sometimes leave a wound that is not suitable for direct closure.

This might be because it is too large to close, and there is not enough loose skin in the area

Alternatively the wound might just be able to be closed but would be very tight, or could distort other features (eg eyebrow or lip) if closed directly. In this case, a local flap might be used.

What types of local flap are there?

There are a number of different types of local flap, and can be described in various ways including the way the flap moves and its shape.

Common flap terminology includes advancement, rotation, transposition, rhomboid, ‘V to Y flap’, and ‘H flap’, to name a few.

The choice of flap for your BCC wound will often depend on factors such as location and size of wound, looseness of skin in the area, and surgeon experience.

How is a flap stitched in place?

Similar to direct closure of a basal cell carcinoma wound, a flap is often held in place by a few deep dissolving stitches.

The skin stitches are usually non-dissolving, but may occasionally be dissolving stitches.

Keeping a source of blood flow in and out of the skin is what makes it ‘a flap’.

What does a local flap scar look like?

Again, this very much depends on the type of flap being used.

A rotation flap may be a long curved scar, while a rhomboid flap leaves a scar that looks a bit like a question mark (or one in reverse).

Sometimes, the surgeon may make other cuts or change the shape of the flap slightly so as to leave less noticeable scars.

The flap itself may also swell up to start with-this usually improves in time and goes down within a few months.

Reconstruction after BCC surgery – direct closure

Learn more about direct wound closure after BCC surgery.

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Reconstruction after BCC surgery – local flap

Find out how local flap techniques are used to repair BCC surgery wounds.

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Reconstruction after BCC surgery – full thickness skin graft (FTSG)

Learn more about full thickness skin grafts used in BCC reconstruction.

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Reconstruction after BCC surgery – split skin graft (SSG)

Discover how split skin grafts are used to reconstruct larger BCC wounds.

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Reconstruction after BCC surgery – forehead flap

Learn more about the forehead flap technique for reconstructing complex BCC defects.

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Reconstruction after BCC surgery – pedicled nasolabial flap

Find out how the pedicled nasolabial flap is used to reconstruct areas affected by BCC surgery.

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Reconstruction after BCC surgery – Secondary Intent Healing

Discover how secondary intent healing allows certain BCC surgery wounds to heal naturally without stitches, offering a less invasive recovery option.

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Important information

Mr Tehrani is one of the UK’s leading Mohs and Reconstructive Surgeons, with a reputation for providing expert, patient-focused skin cancer care. If you have concerns about a skin lesion or are seeking specialist treatment, please get in touch — we’re here to help.

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