Reconstruction of nasal alar defects is a difficult task because of the complex anatomy of the region. The closure technique depends on many different variables like size,location, depth of the defect ,as well as the availability of donor tissues.

We describe a reconstructive option adapted to the anatomical characteristics of the patient. The modified superiorly based nasolabial or cheek flap ,turned over on itself to recreate the alar rim is a good approach ,restoring the initial “bulky” appearance of the ala. Discussions regarding preoperative planning ,closure technique and postoperative secondary revision to recreate the natural grooves are presented.

This modified nasolabial flap can be used elegantly to repair an alar defect by turning it under on itself to recreate the alar rim. The three dimensional shape of the nose was recreated with good cosmetic and functional stable results.