Repair of surgical defects.

Basic skills in elliptical excision are essential for success in dermatologic surgery. Once the elliptical excision has been mastered, the practitioner should progress to variations on the ellipse. These include "curving" the incision, M-plasty, A-to-T closure, O-to-Z closure, and subcutaneous island pedicle flaps. When one of these methods will not suffice, a local flap or a full-thickness skin graft is often a good alternative.