Mehmet Ceber Namik Kemal University, Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Tekirdag / Turkey Abstract: Background: The reconstruction of large, full thickness upper lip defects presents many surgical challenges because of the several cosmetic subunits and unique landmarks. In elderly edentulous patients, functional restoration of the upper lip is a critical priority and large, full-thickness postoncologic defects require tissue recruitment rather than redistribution. I used bilateral inferiorly based nasolabial island flaps in a sandwich-like manner for reconstruction of the large, full-thickness central upper lip defect following excision of squamous cell carcinoma. Case Report: A 90-year-old man was referred for surgical treatment of a biopsy-proven squamous cell carcinoma on his upper lip. Tumour was excised widely with frozen-section control. The result of full-thickness defect involved almost 75% of the upper lip. Bilateral inferiorly based nasolabial island flaps with the facial artery as its pedicle were raised, tunnelled subcutaneously under a bridge of lateral upper lip skin and placed on one another in a sandwich-like manner, such that the skin of the two flaps formed the outer and inner lining of the newly reconstructed upper lip. The postoperative period was uneventful. At the 6th month postoperative examination, color and thickness of the flaps were similar to those of the original skin of the lip. The volume of the upper lip and mouth opening were sufficient. The patient had adequate oral competence. Conclusion: The bilateral inferiorly based nasolabial island flaps in a sandwich-like manner are reliable and effectively used for the reconstruction of large, full-thickness central upper lip defects in a single-stage procedure in elderly edentulous patients and allow a satisfactory functional outcome. Introduction The reconstruction of large, full thickness upper lip defects presents many surgical challenges because of the several cosmetic subunits and unique landmarks [1]. A number of techniques have been described, the choice depending on the extent of the defect in addition to the surgeon’s expertise, indicating that there is no ideal procedure [2-8]. Most of these techniques restore lip continuity, but may cause microstomia, poor oral continence, significant perioral scarring and poor aesthetic outcome [9]. Therefore, for every individual patient, reconstructive goals must be prioritized. Reconstructive priorities for elderly patients with a large full-thickness postoncologic defect are clearly different than those of younger with a remaining deficiency after cleft lip repair. It is believed One-Stage Reconstruction of the Large, Full-Thickness Central Upper Lip Defect with Bilateral Inferiorly Based Nasolabial Island Flaps that in elderly edentulous patients, functional restoration of the upper lip is a critical priority and large, full-thickness postoncologic defects require tissue recruitment rather than redistribution. I would like to present a new reconstruction technique in an elderly edentulous patient with a large, full-thickness central upper lip defect following excision of squamous cell carcinoma. I used bilateral inferiorly based nasolabial island flaps with the facial artery as its pedicle in a sandwich-like manner for reconstruction of the upper lip defect. Case Report A 90-year-old man was referred to our department for surgical treatment of a biopsy-proven squamous cell carcinoma on his upper lip. On physical examination a large tumour which was nodular, painless, hard, and semimobile on the the central upper lip, between 1.5 cm away from the left oral commissure and 3 cm away from the right oral commissure was observed [Figure 1]. Tumour was accompanied by induration and fibrosis in the surrounding tissues. Physical examination revealed no palpable regional Address for Correspondence: Mehmet Ceber, Namik Kemal University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, 59100, Tekirdag / Turkey, Tel: +90(541)776 4290; Fax: +90 282 26203 10; E-mail: mdceber@yahoo.com Received: October 28, 2016; Accepted: December 01, 2016; Published: December 05, 2016 Case Report Advances in Plastic & Reconstructive Surgery © All rights are reserved by Mehmet Ceber ISSN: 2572-6684 Adv Plast Reconstr Surg, 2016 Page 2 of 5