Fig. 7.

An elliptical defect on the lateral mid-thigh is noted (A). A keystone flap is designed to close the defect (B). Incision was made all the way to the deep fascia allowing the flap to advance without tension. Because of the laxity of the thigh, the flap did not need to be closed with a V-Y but rather just an advancement and a tensionless reposition of the flap (C). The thigh at postoperative 6 months shows good functional and esthetic results (D).