A local flap is a piece of skin and underlying tissue that is moved from immediately beside the wound to cover it, while staying attached to its own blood supply. Because the skin comes from right next door, it matches the colour, thickness and texture of the area almost exactly. For facial reconstruction after skin cancer removal, a well-planned skin flap on the face is usually the most natural-looking repair available.
Planning local flaps is core plastic surgery. Miss Rakhee Nayar is one of a small number of UK consultants dual-trained in both Mohs micrographic surgery and plastic surgery, which means the reconstruction is designed by the same surgeon who removed the cancer and knows exactly what has been taken.
Closing directly would pull on the eyelid, nostril rim or lip and distort it.
A graft would leave an obvious patch of mismatched colour or texture.
The area needs bulk restoring as well as surface cover, such as the side or tip of the nose.
Types of local flap
Flaps are described by how the tissue moves. Advancement flaps slide forward. Rotation flaps pivot around a point. Transposition flaps lift over a bridge of intact skin into the defect. Which one is chosen depends on where the spare skin is, where the scars can be hidden and which nearby features must not be pulled out of position.
Most local flaps are performed under local anaesthetic on the same day as the Mohs surgery, once clear margins are confirmed. The flap is designed and marked, raised carefully to protect its blood supply, moved into the defect and stitched in layers. The area the flap came from is closed at the same time, usually in a line that falls within a natural crease.
Healing week by week
Days 1 to 5. Swelling and bruising peak, then start to settle. The flap may look darker or pinker than the skin around it while its circulation adjusts.
Days 5 to 14. Stitches are removed. The scar lines are red and slightly raised.
Weeks 3 to 12. A degree of firmness and puffiness under the flap is normal and settles gradually.
Months 3 to 12. Colour blends, contour refines and scars pale. Occasionally a small revision is offered later to thin the flap or soften a step in the contour.
Book a consultation
To discuss Mohs surgery and reconstruction with Miss Nayar, please use the contact form or call the clinic directly.
If you are facing Mohs surgery and want to understand how your wound would be repaired, this is exactly what a consultation covers. Bring your referral letter or biopsy result if you have one.
What patients say about Miss Nayar
Paul Bridgeman
Google review, Circle Cheshire Clinic, September 2026
5 out of 5
I honestly couldn't have asked for a better experience with my recent Mohs surgery.
The surgeon was absolutely spectacular, incredibly professional, skilled and reassuring. I felt completely confident and in safe hands throughout, and the care and attention given to me were exceptional.
Every member of staff was fantastic. Everyone was friendly, caring, professional and genuinely attentive, which made a potentially worrying experience feel so much easier. The reception team were also excellent, welcoming, efficient and incredibly well organised.
The facilities are first class too: modern, spotless and beautifully maintained. There is plenty of parking right next to the facility, and the surrounding park seating is a lovely added touch for anyone waiting or accompanying a patient.
From the moment I arrived to the moment I left, I felt that I was in the very best hands. It's clear that patient care really matters to this team.
A huge thank you to the surgeon, Miss Rakhee Nayar, and the entire team for looking after me so brilliantly. I wouldn't hesitate for a second to recommend them. Absolutely outstanding from start to finish.
Liam Walshe
Google review, Circle Cheshire Clinic, September 2026
5 out of 5
This is an exceptional private Clinic giving 5 star treatment and outstanding patient care. Miss Rakhee Nayar (Highly Skilled) and her amazing team were absolutely fantastic today providing both the highest quality treatment and exceptional patient care. The approach to the treatment is nothing short of gold standard and pathway to my treatment was carefully explained in advance. I have nothing but praise for Miss Nayar and her lovely team including Kelly and Lisa on the administrative side. Great leadership, skill and outstanding delivery at this excellent Clinic. Huge thanks everyone!
Hilary M.
Top Doctors verified patient, 27 April 2026
5 out of 5
I would highly recommend Ms. Nayar who is a caring extremely talented Plastic Surgeon in Motts surgery. I can’t thank her team enough. Ms. Nayar removed a large BCC from my face and four months later there is no visible sign. My care was exemplary and the outcome exceptional.
Jeremy E.
Top Doctors verified patient, 14 April 2026
5 out of 5
I unreservedly recommend Miss Rakhee Nayar. She is an extraordinary and excellent Mohs and plastic surgeon. Miss Nayar recently removed a BCC from my nose tip and now, 2 months later, there is almost no visible sign of it being done. I’m sure that in a few more weeks all trace will have vanished. She and her team are utterly professional and competent but also disarmingly charming and sensitive. I’ve had a lot of operations and none have been handled so well from start to finish.
Angela B.
Top Doctors verified patient, 15 March 2026
5 out of 5
I'm so happy with the results of my Mohs surgery to have a BCC removed from the bridge of my nose. 6 mths later and you can't see a scar which i was worried about given the sensitive location between my eyes, and it needing quite a few stitches as it was deep routed. Miss Nayar explained everything thoroughly before, during and after my procedure. She was very friendly, professional and made me feel really at ease. I would totally recommend Miss Nayar to anyone looking to have Mohs surgery!
