A combined V-Y advancement–turnover flap for simultaneous perialar and alar reconstruction

A modification to a standard nasolabial flap is described for the simultaneous reconstruction of confluent perialar and full thickness alar defects. The main body of the flap is advanced to cover the external surface of the perialar and alar defects. A side extension to the flap, based only on a dermal blood supply, is turned over, to line the reconstructed alar rim.