When is a flap needed?

Or any complex closure?  These are procedure that reimburse the surgeon more than the simplest of techniques and are often used by doctors who are trying to maximize their billing.  There was a dermatologist who removed very small skin cancers from the face but used a ‘flap’ to close everyone of them when much simpler methods would have sufficed and produced a very good outcome.   Another surgeon simply could not bill less then a complex closure due to his ‘training’ since his expertise is so valuable.  This allowed them to bill the insurance carriers much more and increased their ‘profit’.

You should always be offered OPTIONS on how to close wounds and the risks and benefits of each also reviewed.  Then you should be choosing what works best for you and avoid letting the doctor talk you into what he wants to do.