Back to basics: The subcutaneous island pedicle flap

BACKGROUND. Optimal aesthetic reconstruction of cutaneous defects following excisional surgery is largely dependent on the availability of regional donor tissue that shares a likeness of the original tissue in color, texture, sebaceous quality, and thickness. The island pedicle flap is a useful tool in facial reconstruction because it minimizes regional anatomic distortion and optimizes tissue match. OBJECTIVE. The objective was to review four locations where the island pedicle flap is a well-suited closure tool. METHODS. We review flap planning and specific modifications of the island pedicle flap at four sites of closure, reinforcing its role as an important tool in facial reconstruction. RESULTS. Through careful planning and implementation, the island pedicle flap may be used on the nasal tip, the nasal ala, the upper cheek, and the upper lip for closures with much success. CONCLUSION. The island pedicle flap remains an important tool in the armamentarium for surgeons in the repair of facial defects.