Aesthetic reconstruction of a superficial defect of the upper lip using a hairy preauricular free flap

Reconstruction of the upper lip requires symmetrical reconstruction of hairy male skin according to the aesthetic principle. A moderate defect of the upper lip had nonhairy skin on the upper one-third and hairy skin on the lower two-thirds in a Korean man. A hairy preauricular free flap is useful for correcting superficial-thickness skin defects of the upper lip, when local and regional flaps are not applicable. This flap was harvested from hairy posterior sideburn skin of the preauricular area including a vascular pedicle of superficial temporal artery and vein. The superficial temporal artery and vein were anastomosed with the facial artery and vein in the nasolabial fold area. The trapdoor marginal scar of this free flap required marginal scar revision and debulking twice during the postoperative course. A moderate partial-thickness defect of the upper lip in the male patient can be aesthetically restored using this free flap.