Rhomboid flap tutorial

In this episode of Life by A Thousand Cuts, A/Prof Tony Dicker takes a closer look at rhomboid closures: a practical flap technique for your surgical toolkit.

While most skin cancers don’t present neatly in a diamond shape, traditional rhomboid flaps are based on excising a diamond-shaped defect, which can sometimes remove more tissue than necessary. In this week's episode, A/Prof Dicker explores both the classic rhomboid flap and the modified rhomboid approach, which allows for effective closure of more natural, circular tumour excisions.

He explores the geometry behind traditional rhomboid flaps (including 120- and 60-degree angles), why the modified rhomboid is often better suited for circular defects, how to design and execute a flap that aligns with natural skin tension lines (thus improving both functional and cosmetic outcomes), and a step-by-step walkthrough of a rhomboid flap on the cheek, demonstrating how tissue is rotated into place for optimal closure.

This episode is highly visual, with step-by-step guidance through the design and movement of tissue flaps to close surgical defects while respecting relaxed skin tension lines. You can follow the audio on the podcast or watch the video below for a visual representation.

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Prefer a visual representation? Watch the video version of this episode:

Life by a Thousand Cuts 

This podcast series is designed to help you enhance your clinical decision-making, procedural skills, and confidence in skin cancer management. Focus on real-world cases, surgical techniques and tips, journal article reviews, diagnostic and management insights, and guest interviews with GPs and specialists.

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About A/Prof Tony Dicker

Associate Professor (Skin Cancer) & Course Coordinator MMed (Skin Cancer), The University of Queensland

Tony Dicker has practised full-time Skin Cancer Medicine in Melbourne since 2004, and previously practised in Brisbane. He obtained his PhD from The University of Queensland in molecular biology of skin cancer with Professor Ian Frazer's group at Princess Alexandra Hospital. He then spent three years as a dermatology registrar at the Royal Brisbane and Princess Alexandra Hospitals.

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