Value stream mapping (VSM) is a widely applied method for manufacturing systems design in repetitive and stable industries. A literature review of challenges and modified solutions for lean flow in high-variety low-volume (HV/LV) value streams is carried out. The solutions are categorized according to manufacturing turbulence level. The review shows that existing VSM solutions take their starting point in the original VSM principles and incorporate other relevant works only to a limited extent. Based upon the review, a coherent framework with revised VSM principles that that can be used to develop lean flow in HV/LV environments with medium and high turbulence levels is proposed.