Flaps in Surgery



  • Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with an intact blood supply
  • This is different from a graft, which does not have an intact blood supply and therefore relies on growth of new blood vessels.

Flaps and their vessels



Pectoralis major myocutaneous (PMMC) flap

Pectoral branch of thoracoacromial artery

Deltopectoral flap

2nd to 4th perforator braches of internal mammary artery

Abbe-Estlander flap

Labial vessels

Transverse rectus abdominis myocutaneous (TRAM) flap

Superior epigastric vessels

Supercharged TRAM flap

(Superior + Inferior) epigastric vessels

Latissimus dorsi (LD) flap

Thoracodorsal artery

DIEP (Deep inferior epigastric perforators) flap

Deep inferior epigastric artery

Free fibular flap

Peroneal vessels



  • TRAM is the MC flap used for breast reconstruction
  • DIEP is the BEST flap used for breast reconstruction
  • PMMC is the MC flap used in head & neck reconstruction
  • Free fibular flap is the BEST flap for mandibular reconstruction and Andy Gump deformity.


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