Abstract: Medical devices for repairing defects in tissue, such as perforations in the tympanic membrane of an animal, methods of manufacturing medical devices, methods of implanting a medical device in a defect in a tissue; and methods of repairing a defect in a tissue are described. In one form, a medical device includes an overlay member having multiple arms and defining an overlay member passageway, an underlay member having multiple flaps and defining an underlay member passageway, and a securement member extending through the overlay member passageway and the underlay member passageway. In methods, the multiple flaps of the underlay member can be sequentially advanced into a defect in a tissue, such as a perforation in a tympanic membrane of an animal.