Here we present three cases of extended lateral nasal island flap. These flaps are based on the branches of angular artery that include alar artery and the lateral nasal arteries. The flap is an excellent way of reconstructing nasal tip, dorsum and ala defects up to 1.5 cm in diameter. The release of the flap is extensive. The flap prevents distortion of the alar rim and the nasal tip. It gently redistributes the tissue from the area of the nasal tip to the medial cheek. Due to thickness of the flap, secondary scar revisions and dermabrasion are necessary in greater than 50% of the patients.