General principles · Interactive 3D

Bilobed flap (Zitelli)

An interactive 3D model of the Zitelli bilobed flap: one flap with two lobes at 45° and 90° pivoting on a single point, the primary lobe filling the defect, the secondary lobe filling the primary donor site, Burow's triangle at the pivot and direct closure of the secondary donor.

Interactive — drag to rotate

Schematic demonstration model of the flap geometry.

What to look at

1One continuous flap pivots on a single point one defect radius from the defect edge; arcs at r, 2r and 3r from the pivot set the lobes.
2The primary lobe matches the defect and sits at 45°; the secondary lobe is slightly smaller, sits at 90° and tapers to a tip beyond the 3r arc.
3Play the transposition: the whole flap swings about 45° — lobe 1 fills the defect, lobe 2 fills lobe 1's bed, and lobe 2's donor site closes as a straight line. Burow's triangle at the pivot removes the standing cone.

Hotspots

1Defect — Circular defect of radius r, centred on the 2r arc — classically the lower third of the nose.
2Primary lobe — Same diameter as the defect, centred on the 2r arc at 45°; its tip reaches the 3r arc. Swings 45° into the defect.
3Secondary lobe — Slightly smaller, centred at 90° and tapered to a tip beyond 3r so its donor site closes as a line. Swings 45° into the primary lobe's bed.
4Burow's triangle — Triangle between the pivot and the defect, excised so the flap can rotate without a standing cone (dog-ear).
5Pivot — One defect radius from the defect edge. Both lobes share this single pivot — total arc about 90° (Zitelli), not 180° (Esser).

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