The repair of large or deep alar defects following the surgical removal of melanoma and nonmelanoma skin cancer can be challenging. The repair of such defects has been largely dominated by the use of the nasolabial transposition flap, bilobed flap, and forehead flap. For smaller or more superficial defects, second intention and skin grafts are commonly used.
The tunneled island pedicle flap, also known as the subcutaneous island pedicle flap or the flip-flop flap, has received increased recognition in recent years. Although more commonly used for the reconstruction of auricular defects, the repair of a defect involving the right nasal ala and nasal sidewall is presented.