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Carcinomas on the face are prevalent lesions, with potentially serious repercussions from aesthetic, psychological, and functional perspectives. Surgical reconstruction after excision of these lesions is a challenge for the dermatologic surgeon, requiring good knowledge of the anatomy of the face and accurate implementation of the most appropriate method for each case. Among the various reconstructive procedures are skin flaps, of which the island pedicle flap and its variants stand out. The present article demonstrates the use of the island pedicle flap transferred to the surgical defect through a subcutaneous tunnel, showing the application and characteristics of this method. Reconstruction using a tunneling island pedicle flap after the excision of a facial carcinoma showed good aesthetic and functional results, despite the difficult location of the lesions. This type of flap is a good option for facial reconstruction in difficult areas.

Tunneling island pedicled flap after resection of carcinoma on the face