Reconstruction of Ala, Cheek, and Upper Lip

Abstract

The patient was a 58-year-old woman who presented with a 2-year history of a growth on the skin of the right ala. She was in good health and had smoked 1½ packs of cigarettes a day for 10 years. Examination of her nose revealed a 1-cm slightly ulcerated skin lesion. Biopsy of the area revealed a basal cell carcinoma. Mohs surgery was performed and resulted in a full-thickness loss of the entire ala. The defect extended into the medial cheek where a 2 × 1 cm loss of soft tissue was noted. In addition, a 2.0 × 1.5 cm skin defect of the adjacent upper lip was present (Fig. 26.1). This represented a complex facial defect involving three separate aesthetic regions: nose, cheek, and lip.