One-stage reconstruction of the entire upper lip and the columella with a modified bilateral nasolabial flap

The functional and cosmetic reconstruction of the upper lip after a subtotal defect is a highly demanding challenge, especially when the columella is involved. In the majority of cases, the surgical techniques described in the literature are suitable only for restoring the function and appearance of the upper lip but not for reconstructing adjacent areas. In this article, we present the case of an 85-year-old female patient with an extensive, aggressive and highly invasive basal cell carcinoma of the upper lip and the columella. We describe a modification of the nasolabial flap technique using cheek tissue for the reconstruction of the defect. The modified flap is used for both the full-thickness reconstruction of the subtotal upper-lip defect and the restoration of the function and appearance of the columella. This technique allows excellent cosmetic and functional results to be obtained in a single-stage procedure.