A nasolabial flap borrows skin from the crease that runs between the nose and the corner of the mouth. That crease hides the donor scar well, and the skin it gives is a close match for the nostril, upper lip and inner cheek.
A nasolabial flap is a regional flap raised from the cheek along the smile crease and turned into a nearby defect. It commonly rebuilds the nostril rim, the side of the nose, the upper lip or the lining of the mouth. Blood reaches it through small branches of the facial artery, and the donor scar sits inside a natural crease.
Cheek skin next to the nose has a texture and thickness close to the skin of the nostril and upper lip, and it sits beside a ready made hiding place for the scar. Surgeons take advantage of both facts by marking a strip of skin along the nasolabial crease, raising it with the fat beneath and swinging it into the nearby defect. The base of the flap is left attached so that small vessels from the facial artery keep feeding it.
On the nose, the flap most often rebuilds the ala, the curved rim of the nostril, after a skin cancer has been removed or after trauma. Inside the mouth, the same flap can be turned through the cheek to line the floor of the mouth or the buccal surface, which is useful when a defect is too small to justify a larger regional flap.
Design varies with the job. Some flaps are transferred and inset in a single operation. Others keep a bridge of tissue for two or three weeks, allowing the flap to pick up a new blood supply before the bridge is divided at a second, shorter procedure.
This flap fits small to moderate defects that sit within reach of the cheek crease. Larger or more distant losses need a different plan.
Any tumour or damaged tissue is removed first and the edges are trimmed to a clean shape. Measurements are then taken so the flap is planned to fit without stretching.
A strip of cheek skin is drawn along the nasolabial crease, with its base placed towards the blood supply. The line is set so the donor scar falls inside the natural fold.
Skin and fat are lifted from the cheek, leaving the base intact. The flap is then rotated or tunnelled into the defect and checked for colour before it is fixed in place.
Fine sutures secure the flap. The donor area is closed directly along the crease, which is why the cheek usually flattens into a single quiet line.
Where a bridge of tissue was left, a short second procedure a few weeks later divides it and refines the shape of the nostril or lip.
Facial swelling and bruising are at their worst. Head elevation, cold packs where advised and soft food make these days easier.
Sutures on the face usually come out within this window. Swelling starts to fall and the flap colour evens out.
The scar in the crease is pink but flattening. If a second stage was planned, it has often been done by now and the shape is settling.
Colour and contour keep refining. Small adjustments, such as thinning a bulky flap, are sometimes done once everything has softened.
Most patients get a nostril or lip that looks natural in shape and blends reasonably in colour, though a close observer will still see the repair. Early bulkiness is normal and often needs thinning at a later sitting. The cheek looks a little flatter on the operated side for some months. Where beard skin has been moved, hair may grow in an unusual place and need treatment.
Facial flaps heal well as a rule, helped by the rich blood supply of the face, but complications do happen.
Here the donor site is the cheek crease and the recipient site is the nose, lip or mouth lining. Each needs slightly different attention.
Nearby facial skin usually matches far better. The cheek crease supplies tissue of similar colour and thickness within reach of the nose and lip.
Staged division of the pedicle is planned from the outset in many designs. It is part of the technique, not a sign of failure.
The line is placed inside the smile crease, where it usually settles quietly. It stays visible on close inspection, yet most people do not notice it in conversation.
Small refinements such as thinning a bulky flap or adjusting the nostril rim are common and are usually done after the tissue has softened.
Facial reconstruction at Elegance Clinic in Surat is planned around how the face looks and works together, with Dr. Ashutosh Shah discussing staged and single stage options before any date is fixed.
This is a technique page, so it does not carry its own price. A nasolabial flap is one way of rebuilding a defect, and cost depends entirely on the treatment it is used within, including the extent of any tumour removal, the anaesthetic and whether a second stage is planned.
Bands for the underlying treatments are shown on their own pages, and a written estimate follows examination so families can plan before admission.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →A technique does not carry its own price. The figure follows the treatment it belongs to, such as removal of a skin cancer or repair after injury, and reflects theatre time, anaesthesia, stay and any second stage. An estimate is written after examination.
The face has a generous blood supply, so these flaps usually heal well. Recognised problems include partial tip loss, bulkiness, asymmetry and infection. Tobacco in any form raises those risks and is best stopped well before surgery.
Swelling and bruising settle over the first two weeks, and facial sutures usually come out within that time. Most people return to office work at around two weeks. Full softening of the scar takes several months.
Shape and colour usually blend well because the skin comes from nearby. A repair remains detectable on close inspection, and early fullness of the flap often needs thinning at a later, smaller procedure.
Large or full thickness nasal defects need a forehead flap instead. Heavily scarred or irradiated cheek skin, continued smoking and unwillingness to accept possible hair growth on transferred skin also point elsewhere.
Where a bridge of tissue is left in place, it is usually divided a few weeks later, once the flap has picked up blood supply from its new bed. Exact timing is judged by how the tissue looks at review.
The defect or lesion is examined, cheek skin is assessed for laxity and scarring, and your health, medicines and smoking history are reviewed. Options are compared with photographs, and the number of stages is agreed before booking.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
