The answer is E. Island pedicle flap. 

The island pedicle flap is a type of advancement flap commonly used for medial cheek defects. The closure can often be camouflaged in the melolabial fold.  After these flaps are freed from the surrounding skin, they retain their blood supply through a deep subcutaneous or muscular pedicle and are advanced into adjacent defect.

The rhombic and nasolabial transposition flaps are unilobed flaps which displace wound closure tension to sites distant to the defect site.  This involves transposion of flap tissue over normal skin into the defect and closing the secondary defect.  Skin grafts are separated completely from their blood supply and placed into defect for repair.  Rotation flaps have arcing incision lines which are typically much longer than the width of a defect to ensure recruitment of tissue laxity.

 

References:

Campbell LB; Ramsey ML. Transposition island pedicle flaps in the reconstruction of nasal and perinasal defects. J Am Acad Dermatol. 58(3):434-6, 2008 Mar.  PMID: 18280340

 

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