The Bilobed flap was first described in 1918 for use in nasal tip reconstruction. This flap is a “rotational flap” that distributes the skin tension required for closure of a particular defect, over a wider area. Bilobed flaps are commonly used for reconstruction of many facial wounds following removal of skin cancers by primary excision or Moh’s micrographic excision.
The primary defect (black circle) is outlined, and then two flaps (red semi-circle and red triangle) are designed immediately adjacent. Each of these flaps are slightly narrower than the area next to it. Each flap can effectively rotate up to 90 degrees. The flaps must be elevated (or undermined) to their bases in order to be effectively rotated. Although this flap does require additional scar placement beyond the area of tumor removal, it has the advantage of using adjacent skin with similar color and texture for the reconstruction.