For Apert syndrome, multiple surgeries are the common fate of these patients. After multiple surgeries, I was faced with a pair of hands that were full of sores. Although I was used to seeing it, I had some whimsical thoughts about these hands: could I fully leverage the results of the previous surgeries and break new ground? I don’t need to elaborate on the importance of a separate thumb for a person. In the case of Apert deformity, the reconstruction of a new tiger’s mouth to allow for independent movement of the thumb has always been a major concern for the surgeon. I have been asked by physicians whether to consider reconstructing a new tiger mouth with a free flap – a tissue from outside the hand that has its own blood supply? Indeed, it is a good idea! But it is more invasive, can there be a simpler and more effective way? I noticed that the previous surgery had already resulted in some expansion of the skin area of the patient’s tiger’s mouth, although using this additional area of skin, using conventional methods such as Z-plasty, pentaplasty, etc., would certainly not be sufficient. However, I did not want to let these results go down the drain, and I wanted to obtain the desired results with less trauma. No implants, no flaps from far away, just a local solution based on what had been done before, with an improved thumb in both axis and appearance, and a maximum enlargement of the tiger’s mouth – that was my “whimsy”.