The Turnover Nasolabial Flap for Full-Thickness Alar Reconstruction: A Single-Stage Technique for Optimal Cosmetic and Functional Results

Background: Full-thickness alar defects require complex reconstruction of the nasal lining, framework, and skin. While the forehead flap is the standard, it involves multiple stages. This study presents the nasolabial turnover flap as a single-stage alternative offering both functional and aesthetic advantages. Method: Over a two-year period, 16 patients with basal cell carcinoma underwent alar reconstruction using a folded nasolabial turnover flap with cartilage grafting. Candidates had thick nasal skin and adequate cheek laxity. Reconstruction followed the nasal subunit principle, and a nasal conformer was used postoperatively. Results: All flaps survived with no infections. Minor complications included two cases of venous congestion and one case of partial nasal obstruction requiring revision. Donor sites healed well with concealed scarring. At 12 months, outcomes were functionally and cosmetically satisfactory with high patient satisfaction and minimal need for secondary procedures. Conclusion: The nasolabial turnover flap is a reliable, single-stage solution for full-thickness alar reconstruction in select patients. It offers excellent color match, structural support, and minimal morbidity, making it a valuable alternative to multistage techniques.