Repair of the philtrum: an illustrative case series

Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome.

This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone.

The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.