ABSTRACT
Flap classification is based on an evolving paradigm as new uses and new flaps are discovered. The earliest report of a facial flap (the midline forehead flap) is found in the Sushruta Samhita, a Hindu holy book, in 600 bce (1). Flap development was largely ignored or relegated to the unholy in the period between the emergence of Buddhism in India to the 16th century (2). In the 1500s, Tagliacozzi perfected the arm-pedicled technique of nasal reconstruction that became known as the Italian method. The Hindu method was introduced to English speaking society by ‘‘B.L.’’ in a letter to the Gentleman’s Magazine in London in 1794 (3). This spawned a new era and signaled the rebirth of reconstructive surgery (4).
