A local flap moves skin from beside the wound to cover it, keeping its own blood supply. Planned and carried out by Consultant Plastic Surgeon Miss Rakhee Nayar.
Women in the UK dual-trained in Mohs and plastic surgery
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
Skin from next door
What is a Local Flap?
A local flap is a piece of skin and underlying tissue 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 closely. On the face, a well-planned flap is often the most natural-looking repair.
Choosing the repair
When is a Local Flap Used?
A local flap is chosen when a wound is too large or deep to close directly, or when closing it would pull on a nearby feature.
It is also used where a graft would leave an obvious patch of mismatched colour or texture.
Planning flaps is core plastic surgery. The design depends on where the spare skin is, where the scars can be hidden and which features must not move.
The wound is too large or too deep for direct closure.
Closing directly would pull on the eyelid, nostril rim or lip.
A graft would leave an obvious patch of mismatched skin.
The area needs bulk restoring as well as surface cover.
Planned around you
Types of Local Flap
Flaps are described by how the tissue moves. Which one is chosen depends on where the spare skin is and where the scars can be hidden.
Two flaps used often on the nose have their own pages: the nasolabial flap and the forehead flap.
Advancement Flaps
The skin slides forward into the wound, with the scars placed along natural lines.
Rotation Flaps
The skin pivots around a point to cover a rounded wound.
Transposition Flaps
The skin lifts over a bridge of intact skin into the wound, borrowing from where there is spare.
Own Blood Supply
Every flap stays attached to its blood supply, which helps it heal and match the surrounding skin.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Local Flaps Are Used
Local flaps are used across the face, wherever there is spare skin nearby and a scar can be hidden in a natural line.
Read about the other reconstruction options: direct closure, healing by secondary intention, full-thickness skin graft, split skin graft, nasolabial flap and forehead flap.
The Nose
The Cheek
The Forehead and Temple
Around the Eye
Around the Lips
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
The area is numbed with local anaesthetic, so you stay awake but should not feel pain.
Once the margins are clear, the flap is designed and marked on the skin.
The flap is raised carefully to protect its blood supply.
It is moved into the wound and stitched in layers.
The area the flap came from is closed at the same time, usually in a natural crease.
Other options
Other Reconstruction Options
A local flap is one of several repairs. Depending on the size and site of the wound, one of these may suit better.
Direct Closure
A fine line of stitches, placed in the natural creases of the face. Read more
Full-Thickness Skin Graft
Skin taken from a hidden donor site and laid into the wound. Read more
Nasolabial Flap
Cheek skin from beside the nose, used to rebuild the side of the nose. Read more
Forehead Flap
Forehead skin used to rebuild larger defects of the nose, in stages. Read more
Healing week by week
Recovery and Healing
Recovery after a local flap takes a little longer than a simple closure. Miss Rakhee Nayar gives you a clear aftercare plan and sees you again to check the repair.
- Days 1 to 5: swelling and bruising peak, then start to settle. The flap may look darker or pinker than the skin around it at first.
- Days 5 to 14: stitches are removed. The scar lines are red and slightly raised.
- Weeks 3 to 12: some 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.
- Protect the area from the sun while the scars mature.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
Will the flap match my skin?
Usually closely, because the skin comes from right beside the wound. It can look darker or pinker for the first few weeks while its circulation adjusts.
How many scars will there be?
A flap leaves more lines than a simple closure, because skin is moved. They are planned to sit in natural creases and borders where they are least noticeable.
Is it done on the same day?
Usually, yes. Most local flaps are carried out under local anaesthetic on the same day as the Mohs surgery, once the margins are clear.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All surgery leaves a scar. Miss Nayar’s plastic surgery training shapes the flap design, placing the lines along the natural creases and borders of the face so they settle well over time.