De-epithelialization and over-flapping in plastic surgery

Contour defects resulting from trauma, from the excision of a neoplasm, or present at birth, may be restored in a number of ways, and the material used may be autogenous, homogenous, heterogenous, or synthetic in nature. The use of Silastic implants is currently fashionable, but despite the manufacturer's claims, there is no foreign material which the body will accept permanently as its own. Implants are easy to procure and to shape, and their use can sometimes simplify a surgical procedure, but there is no doubt that where autogenous material is available, it will almost always give the best and most permanent result. This paper illustrates the versatility of simple de-epithelialization and over-flapping procedures in restoring contour defects, and is also a plea for the use of living tissue where it is readily available.