Modified Spear flap for the reconstruction of a full-thickness defect of the nasal ala

Various options are available for the reconstruction of full-thickness defects of the nasal ala with different advantages and disadvantages, but none are fully satisfactory. We present the case of a 57- year-old man with a recurrent basal cell carcinoma of the right nasal ala and nearby cheek and upper lip. Tumour clearance was achieved after two stages of 'fresh/frozen' Tübingen technique, resulting in a 2.0×2.0 cm full-thickness defect of the lateral right ala. The wound involved the alar rim, groove and adjacent check and upper lip. Reconstruction was successfully achieved with a nasolabial turnover flap (modified Spear flap) in a single stage. The surgical procedure and subsequent outcomes are illustrated. Our experience shows the effectiveness of the nasolabial turnover flap for a single-stage repair of full-thickness defects of the nasal area and adjacent tissue.