Abstract: Objective: To assess the clinical efficacy of double subcutaneous island pedicle flap in repairing the defect after alar basal cell carcinoma(BCC) excision. Methods: 50 patients with alar BCC were treated with a double subcutaneous pedicle island flap from October 2022 to March 2024. The surgical margins were determined based on the risk of tumor recurrence, and two subcutaneous island pedicle flaps were designed. After the tumor was excised, the flaps were created and rotated to cover the defects, followed by meticulous suture closure. Results: All flaps survived postoperatively without necrosis or ischemic blisters, and the wounds healed by primary intention. During the follow-up of 1 to 12 months, no recurrence was observed. The flap color matched the surrounding skin well, with minimal scarring and symmetrical bilateral alae nasi. Conclusion: Using double subcutaneous island pedicle flap to repair the defect after alar BCC excision achieves satisfactory aesthetic outcomes with minimal complications.

Key words: subcutaneous pedicle flap, basal cell carcinoma, repair