Reconstruction of a Full-Thickness Right Nasal Ala Defect After Basal Cell Carcinoma Excision Using a Nasolabial Flap: A Single-Stage and Functional Approach

Basal cell carcinoma (BCC) is the most prevalent form of non-melanoma skin cancer, involving exposed areas such as the nose. Its location in this anatomically and aesthetically sensitive region poses significant diagnostic and therapeutic challenges, requiring a balance between complete tumor removal and preservation of nasal function and appearance. We present the case of a 64-year-old female cleaning worker with an eight-year history of a gradually enlarging lesion on the right nasal ala, which was diagnosed as a micronodular BCC following biopsy. The micronodular BCC is associated with more aggressive behavior and a higher risk of recurrence. This is why wider surgical margins and careful management are necessary in this type of disease to ensure complete tumor eradication. The patient underwent surgical excision with a 5 mm margin, including the full thickness of the nasal ala. Immediate reconstruction was successfully carried out using a nasolabial flap, a versatile local flap renowned for its excellent match in color, texture, and thickness to the nasal skin, along with its reliable vascular supply and minimal donor site morbidity. Histopathological examination showed free-margin, complete tumor resection and no lymphovascular or perineural invasion. The patient's postoperative evolution was uneventful, with no flap-related complications. At the two-month follow-up, the surgical site had healed with a scar that was discreetly camouflaged within the natural nasolabial fold, preserving nasal contour and facial symmetry. This case highlights the functional and cosmetic benefits of the nasolabial flap for full-thickness nasal ala defect reconstruction, as timely reconstruction of the defect using local flaps not only enhances the functional and cosmetic outcomes but also results in better patient quality of life.