Island Flap

The island flap described by Converse (1977), based on one or both trochlear arteries, is also useful for reconstructing defects in the nasal dorsum (Fig. 5.9). The bridge of skin between the island flap and the primary defect can be partially or completely divided if the flap shows livid discoloration due to excessive pressure on the pedicle.

Fig. 5.8a Outlining a superiorly or inferiorly based bilobed flap. b Closure of all defects. (Distortion of the lower eyelid should be avoided!)

Bilobe Flap
Fig. 5.9 Island flap based on the supratrochlear artery (Converse 1977). a The flap is outlined, and subcutaneous dissection is performed without vascular injury. b The bridge of skin between the flap and defect is undermined, and the island flap is pulled through. c Closure of all defects.
Rieger Flap
Fig. 5.10 Trapezoidal V-Y advancement of Rieger (can also reach the nasal tip; see Fig. 5.14).

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