The authors report the use of a vascular island nasolabial flap with facial arterial pedicle and reverse blood flow inspired by the flap described by C. Le Quang in an unpublished indication. This case concerns a 64-year-old patient with a large botryomycoma of the columella. The size of the defect following excision and the length of the columella authorized reconstruction using a split thickness nasolabial reverse flap. At one year post-operatively the result was aesthetic and defatting was unnecessary. This flap is used to repair defects of the nasal lateral wall and ala. In some conditions, it can be used to repair the collumela, providing a safe vascular support in one stage.
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