Patients often present to their primary care physicians for removal of skin lesions for diagnosis or to improve cosmesis. Often, the lesions are located on areas of the body where the skin does not provide a great deal of laxity, such as the face and extremities. Thus, closure of the secondary defect resulting from removal of the lesion is difficult. A simple technique that utilizes subcutaneous island pedicle flaps may be used in such situations. Subcutaneous island pedicle flaps facilitate closure of wounds and avoid complications often encountered with the use of alternative techniques such as rotation flaps, transposition flaps and skin grafts.