Island flaps which are nourished by a single artery and vein may be useful in head and neck reconstructive surgery. Requisites for use are: tissue being transferred must have identifiable nutrient vessels which alone can maintain survival of part being moved, and anatomic site and length of nutrient vessels must allow the part being shifted to be placed in recipient area without undue tension on delicate vascular pedicle. The greatest advantages of this type of reconstructive procedure are (1) most are completed in a single, primary stage; (2) color match of skin of the forehead and facial defects is good; and (3) since island flaps carry their own nourishing vessels, they may be used in irradiated areas. Scarring in the donor site is the chief problem associated with island flaps; this can usually be minimized by careful planning.