Lip-lift Flap for Columellar–Nasal Base Reconstruction after Mohs Surgery

Summary: – Reconstruction of columellar and nasal base defects remains challenging because of the region’s aesthetic and functional importance. Squamous cell carcinoma in situ in this area often necessitates Mohs micrographic surgery, which can result in composite tissue loss that is difficult to restore with conventional techniques. We report the case of an 89-year-old woman presenting with a 1-cm lesion at the left nasal base and columella. The tumor was excised in a single Mohs stage with histologically clear margins. Reconstruction was achieved using a lip-lift–style advancement flap designed along the subnasal border. The flap provided excellent color and texture match, preserved nasal airway function, and obviated the need for cartilage grafting. At 1-month follow-up, healing was uneventful, with a concealed donor-site scar and only a mild columellar deviation that caused no functional or aesthetic concern. The patient expressed high satisfaction with the outcome. This case highlights the versatility of the lip lift, typically an aesthetic procedure, as a reliable option for oncological reconstruction of nasal base and columellar defects.