[An extremely long Abbé flap for simultaneous reconstruction of a defect of the upper lip and the columella]

X-ray treatment of a small haemangioma of the upper lip in a child led to severe health consequences, about 20 years later. Besides an extremely hypoplastic upper lip with whistle tip deformity, an exulcerated basal-cell carcinoma had developed upon the columella and the lower part of the nasal tip. The goal of the operation was to perform a radical excision of the tumor but also to obtain an aesthetically pleasing reconstruction of the upper lip and a simultaneous covering of the defect, resulting from the tumor excision on the columella and the nasal tip. To achieve this, we have chosen an Abbé-flap, with an extremely long cutaneous pedicle. While in Abbé-flaps the relation between muscular and cutaneous part usually is about 1:2, in this case it was about 1:5. With this flap it was possible to cover in one stage the defect in the upper lip, the columella and the nasal tip.