Use of the oblique island flap in excision of small facial tumors.

Reconstruction with the oblique sigmoid island flap, which we contrived as a subcutaneous pedicle flap, is performed as follows: the small triangular skin flaps, about 1 to 2 mm in length on each side, are excised from both sides of a round defect following tumor excision in a direction corresponding to the wrinkle line, and a subcutaneous island flap which has a width equal to the defect and has shifted about half the distance of the defective area in parallel with the wrinkle line is advanced and sutured. Our technique is thought to be highly effective from a cosmetic point of view because reconstruction of the defects following excision of small tumors that occur in sites with delicate eminence, such as the area between the inner canthal region and the cheek, the site along the nasolabial fold, and around the alae, often tends to fail to achieve cosmetically good results when conventional local skin flaps are used.