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J Reconstr Microsurg 2002; 18(5): 411-412
DOI: 10.1055/s-2002-33025
LETTER TO THE EDITOR

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

On: Free Tattoo Flap

Geoffrey G. Hallock
  • Division of Plastic Surgery, the Lehigh Valley Hospitals, Allentown, PA
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Publication History

Publication Date:
31 July 2002 (online)

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To the Editor

Decorative tattooing may be socially controversial, but is an ubiquitous phenomenon dating to antiquity.[1] Medical adaptations have utilized this technique of micropigmentation for enhancement or creation of body parts,[2] [3] [4] camouflage of deformities,[5] and even concealment of surgical incisions.[6] Every tattoo is not just a work of art, but an important part of the individual's body image, often with hidden significance that may be difficult to divulge.[1]

These underlying psychological aspects must always be considered whenever any proposed surgical intervention must violate a tattooed area. This concept is exemplified in an obese and well-tattooed male who needed a staged reconstruction of his left thumb, which had been blown off in a July 4th firecracker incident. He had not tolerated a pedicled groin flap, so a lateral arm free flap was chosen as the thinnest yet largest alternative for providing soft-tissue bulk prior to a big toe transfer to later make a radial post. The names of his children had been tattooed on the ribbons below a large eagle on his left shoulder. These were carefully preserved intact within the boundaries of the transferred lateral arm flap as a free tattoo flap, and now legibly grace the base of his proposed thumb instead! (Figs. 1-3)

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