Advancement flap to cover a defect between the junction of the alar base and the upper lip

Reconstruction following excision of skin lesions at the cosmetically sensitive junction between the alar base and upper lip continues to be challenging for surgeons. We describe an advancement flap from the nasolabial fold area to reconstruct such defects. Our case demonstrates a gentleman with a clinically diagnosed BCC between the alar base and upper lip. An advancement flap from the nasolabial area was designed to reconstruct the defect, with two Burrow's triangles excised to prevent standing cones. The scar of the two Burrow's triangles falls over the nasolabial fold, resulting in the integration of the scar within the natural line. This flap design also maintains of the level of the upper lip, the shape and position of the nostril, and minimises flattening of the philtrum. Excellent cosmetic results were seen six weeks post-op.