ABSTRACT
Flaps share most of the difficulties that can arise with simple excision and primary closure but there are added potential problems related to undermining, interruption of blood supply and the movement of the tissue. Pure advancement flaps are simple to conceive but have limited use because the flaps have limited elasticity. In this case the defect is only covered by stretching the flap rather than transferring the tension to an area of lax skin. A-to-T closure is a method that allows the surgeon to avoid cutting across chosen structures such as the eyebrow, lip and hairline. A nasolabial flap is a special example of transposition and allows defects on the lower part of the nose to be filled with cheek skin. It is important to avoid a tenting effect because any bridge across the groove at the side of the nose is easily noticeable.
