[Upper nasolabial flap: improving the surgical technique]

The upper nasolabial flap was initially described by Kilner in 1937, and popularized by Préaux in 1994. It is an interesting solution for the reconstruction of the ala thanks to its simplicity and reliability. Nevertheless, the results obtained with the original technique could be improved because of scars on the side of the nose and the absence of nostril groove. That is why we propose a modification of the surgical technique. We present the case of an 82-year-old female patient who presented with a basal cell carcinoma of the right nasal wing rebuilt by a modified upper nasolabial flap. The skin triangle above the defect, which separated it from the flap pedicle, was not sacrificed but dissected forward from behind, to the junction between the nasal dorsum and the lateral side of the nose. The next step, key step of our technique, was removing the epidermis from the flap pedicle. The nasolabial flap was thus slid forward to the alar loss of substance, thereby recreating a nostril groove nose with a single scar. The scar was thus more discrete than with the conventional technique. The other steps did not differ from the conventional technique. The immediate postoperative course was uneventful. Rebuilding a loss of transfixing matter of the ala with a modified Préaux flap technique allows obtaining a simple, reliable, and elegant reconstruction. It presents all the advantages of the conventional upper nasolabial flap with particular care given to the cosmetic appearance of nasal reconstruction.