The Cake Flap: a new technique for serial excision of benign cutaneous lesions

Large congenital melanocytic naevi and other circular benign skin lesions are often excised by serial ellipses in stages. With this conventional technique, normal skin is sacrificed when excising 'dog ears', resulting in an elongated scar. The 'Cake Flap' is a new technique for serial excision of benign skin lesions that allows more than half the area to be excised at the first operation without the appearance the 'dog-ears' that would occur if this was done using the serial excision technique commonly employed. We have used the Cake Flap in four patients with congenital melanocytic naevi to good effect. The design overcomes the shortcomings described of traditional elliptical serial excision without the use of tissue expansion.