Subnasale flap for correction of columellar deformity

Background: Columellar defects or deformities are challenging problems to correct. Many different techniques have been described, yet none are ideal, especially for the purpose of aesthetic improvement. Methods: Local flaps are designed from the subnasale region extending into the nasal floor. It is a one-stage procedure that transfers well-matched skin to the columella. Flaps are rotated medially to improve various types of columellar deformities. The flap was used in 20 cases for defective, narrow, and deviated columella. Results: Results in all of the cases were satisfactory, with minimal complications. Conclusions: The procedure is relatively simple, and primary closure of the donor site is possible without causing external deformity. The subnasale flap can be fashioned without a visible donor-site scar. It is indicated for partial to total reconstruction of columellar defects, aesthetic improvement of narrow columella, and correction of deviated columella.