Ø Bilobed flaps are used when the defect created by the primary flap (i.e., the banner flap) is too large to close primarily.Ø The flaps are designed on a 45- to 90-degree axis to the primary defect and the flaps are elevated in the subcutaneous plane.
Ø Generally, the primary flap may be drawn somewhat smaller than the defect and is designed, as much as possible, to place the scars along minimal tension lines and within natural skin creases. Flaps designed at 45-degree angles minimize dog-ear formation.
Ø The resultant scars are complex and may be quite conspicuous.
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