Further experience with upper lip flaps for reconstruction of the ala nasi and alar base defects.

Reconstruction of the ala nasi and the alar base presents problems because of complex contours, skin color and texture, and limited availability of mobile, adjacent skin. A large percentage of basal cell carcinomas occur on the nose. When excised with adequate safety margins, these lesions create a defect too large for direct repair. This paper describes the use of the upper lip flap for reconstructing alar base defects and reconstructing the inner lining of the ala nasi in full-thickness defects of the ala nasi as an alternative to other procedures proved to be effective on this region. The base of the flap rests on the base of the columella. It is raised just over the underlying orbicularis oris muscle. The resulting donor defect is closed primarily. The outer aspect of defects of the ala nasi are covered with either a full-thickness skin graft, a forehead flap, or a cheek flap. The upper lip flap was used on 10 patients to reconstruct full-thickness defects of the ala nasi, for which an alar base needed to be reconstructed. The results were satisfactory in most patients. An upper lip flap can be used safely to reconstruct the ala nasi and alar base defects either alone or in combination with other flaps.