This is Richard Allen at the University of Iowa. This video demonstrates the use of a Rhomboid flap to close a left upper lid defect after excision of a skin cancer. The flap is designed and a number 15 blade is used to make an incision through the skin and underlying orbicularis muscle. Monopolar cauteryis then used to raise the flap. The remaining portion of the defect is then widely undermined. The flap is then transposed into position. A deep 5-0 Vicryl suture is then placed to relieve tension from the transposition. The skin is then closed with interrupted 6-0 prolene suture placed in an interrupted fashion. At the end of the case, the skin should demonstrate minimal tension at the wound edges.