Background: An extensive basal cell carcinoma that reached the maxillary sinus was removed. In the first reconstructive stage, we closed the primary defect on the sinus with a rotation-transposition flap. The distal portion of the flap necrosed, producing a defect in the nasolabial fold that left the sinus open and caused upward retraction of the upper lip. Objective: The defect of the nasolabial fold had to be corrected and the sinus closed; in a later stage, the retractile scar that appeared on the upper lip also needed correction. Methods: We used a delayed, elongated, right paramedian flap to correct the defect on the nasolabial fold and to close the sinus. We then corrected the retractile scar on the upper lip with a V-Y advancement flap. Results: The defect was closed without complications and the V-Y flap worked in returning the upper lip to its anatomic position. Conclusion: The midforehead flap is best for the reconstruction of the tip and the alar areas of the nose, including the near nasolabial fold. The V-Y advancement flap is an easy flap that allows one to correct retractions around the facial orifices. In dermatologie surgery, the final results must be as esthetic as possible.
Microcystic adnexal carcinoma arising in the subcutaneous tissue of the upper lip
