The nasolabial flap uses cheek skin from beside the nose to rebuild the nose, leaving a scar in a line the face already has. Planned and carried out by Consultant Plastic Surgeon Miss Rakhee Nayar.
Women in the UK dual-trained in Mohs and plastic surgery
of 36 patients would recommend Miss Nayar (PHIN, September 2026)
Cheek skin for the nose
What is a Nasolabial Flap?
The nasolabial flap uses the well-supplied skin of the cheek beside the nose, along the fold that runs from the corner of the nostril to the corner of the mouth.
That fold, the nasolabial crease, is why the technique works so well: the scar left behind sits inside a line the face already has.
Choosing the repair
When is a Nasolabial Flap Used?
Nasolabial flaps are a mainstay of nasal reconstruction after skin cancer removal, particularly for the ala, the curved outer wall of the nostril.
Cheek skin is a close match for the skin of the nose in colour, thickness and oil content.
On a curved, prominent part of the face, a flap tends to blend better than a graft, which can leave a flat, mismatched patch.
Wounds of the nasal ala or the side wall of the nose, most often after removal of a basal cell carcinoma.
Wounds that need both surface cover and some bulk to rebuild a natural curve.
Sites where a graft would leave a flat, mismatched patch.
Wounds of the upper lip and the floor of the nostril.
Planned around you
One Stage or Two
Some nasolabial flaps are completed in a single operation. Others stay attached to the cheek by a bridge of tissue that carries their blood supply while they settle.
A two-stage approach is less convenient, but often gives a better contour on the nostril rim. Which route is right is discussed with you before surgery.
Single Stage
The flap is moved and stitched in one operation, with the cheek closed in the fold.
Two Stages
The flap stays attached to the cheek for about three weeks, then the bridge is divided in a short second procedure.
Hidden Scar
The cheek is closed directly, leaving a fine line within the nasolabial fold.
Day Case
Most nasolabial flap surgery is carried out under local anaesthetic as a day case.
Clinical background
Why Choose Miss Rakhee Nayar for Your Reconstruction?
Reconstruction is where the result you live with is decided. With over 20 years of surgical experience, Miss Rakhee Nayar brings training in both skin cancer surgery and plastic surgery to the same operation.
One Surgeon, Start to Finish
Miss Nayar is one of fewer than 10 women in the UK dual-trained in both plastic surgery and Mohs micrographic surgery.
That means the surgeon who checks your margins under the microscope is the same one who plans and carries out the repair, knowing exactly what has been removed and why.
The Dual-Specialist Advantage
This combination means the person who removes your cancer is the same person who plans and carries out the repair. Miss Nayar is accredited as both a Consultant Plastic Surgeon and a Mohs surgeon.
- Cancer removal with every margin checked
- Repair chosen for your face and your wound
- One consultant from consultation to follow-up
- Plastic surgery training (FRCS Plast)
Training and Appointments
Miss Nayar is a Consultant Plastic Surgeon at Mersey and West Lancashire Teaching Hospitals NHS Trust, and sees private patients at Fairfield Independent Hospital and Circle Cheshire Clinic.
- She chairs the Mohs Surgery Training Interface Group (JCST), the national committee for Mohs fellowship training in the UK.
- She holds an MBChB with Honours and an MD from the School of Cancer Studies at the University of Liverpool.
- She is a Fellow of the Royal College of Surgeons of Edinburgh (FRCS Plast) and holds the European Board of Hand Surgery Diploma (EBHS).
- She is an active member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Medical Association.
Where it is used
Where Nasolabial Flaps Are Used
The flap is most often used to rebuild the side and outer wall of the nose. See also Mohs surgery on the nose.
Read about the other reconstruction options: direct closure, healing by secondary intention, local flap, full-thickness skin graft, split skin graft and forehead flap.
The Nasal Ala
The Side Wall of the Nose
The Floor of the Nostril
The Upper Lip
The Nostril Rim
Request an e-Consultation
Miss Nayar offers a convenient e-Consultation service for patients seeking a specialist opinion from across the UK and overseas. This secure digital pathway enables remote assessment of skin lesions and concerns, providing a prompt clinical recommendation.
It is an ideal first step for those considering Mohs surgery or reconstruction before travelling for an in-person appointment.
Step by step
What the Procedure Involves
Most repairs are carried out under local anaesthetic on the same day as the Mohs surgery, once the microscope has confirmed the margins are clear. Each step is explained as it happens.
Years of surgical experience
The area is numbed with local anaesthetic, so you stay awake but should not feel pain.
Once the margins are clear, the flap is designed and marked along the nasolabial fold.
It is raised with its blood supply protected and moved into the wound on the nose.
It is stitched in layers, and the cheek is closed directly within the fold.
If the flap is staged, the bridge is divided in a short second procedure about three weeks later.
Other options
Other Reconstruction Options
The nasolabial flap is one of several ways to rebuild the nose. Depending on the size of the wound, these may also be considered.
Local Flap
Neighbouring skin moved across on its own blood supply for a close match. Read more
Full-Thickness Skin Graft
Skin taken from a hidden donor site and laid into the wound. Read more
Forehead Flap
Forehead skin used to rebuild larger defects of the nose, in stages. Read more
Healing by Secondary Intention
The wound is dressed and left to heal on its own, in the right sites. Read more
Healing week by week
Recovery and Healing
Early swelling is part of this repair and settles over the following weeks. Miss Rakhee Nayar gives you a clear aftercare plan and sees you again to check the repair.
- Days 1 to 5: swelling and bruising around the nose, cheek and sometimes the eye. The flap looks bulky and pink.
- Days 5 to 10: stitches are removed, and swelling starts to reduce.
- Week 3: if the flap is staged, the bridge is divided at this point.
- Weeks 4 to 12: bulkiness settles gradually, and the shape of the nostril becomes clearer.
- Months 3 to 12: scars pale and soften.
- A minor thinning or contour refinement is sometimes offered at around six months.
In Patients' Words
Patients Feedback
What Our Patients Say
Concerned About Skin Cancer?
Book a Specialist Assessment
Early assessment usually means a smaller operation and a simpler repair. Contact Miss Rakhee Nayar’s clinic for an assessment by a consultant dual-trained in Mohs and plastic surgery.
or Call Us Now
07740 306144
Circle cheshire Clinic
The Courtyard, Hall Ln, Wincham, Northwich CW9 6DG, United Kingdom
07740 306144
contact@mohssurgeon.co.uk
Schedule Your Visit
Where to See Miss Nayar
Miss Rakhee Nayar provides specialist Mohs and reconstructive surgery at Circle Health Cheshire Clinic. This modern, private facility offers expert care in a discreet environment for patients across Cheshire and the North West.
Frequently Asked Questions
We're Always Here to Help You
Will I need two operations?
Sometimes. Some flaps are completed in one stage. Others stay attached to the cheek for about three weeks before a short second procedure divides the bridge. Miss Nayar discusses which is right before surgery.
Where will the scar be?
Mainly in the nasolabial fold, the natural line between the nose and the corner of the mouth, where it tends to be well hidden.
Why not a skin graft?
On the curved outer wall of the nostril, a graft can leave a flat patch that does not match. Cheek skin is a closer match for nasal skin and can rebuild the curve.
Will I be awake for the surgery?
Yes. Most repairs are carried out under local anaesthetic, so you stay awake and can talk to the team throughout. It also avoids the need for a general anaesthetic.
How long will it take?
It depends on how many Mohs layers are needed before the repair, which cannot be known in advance. Plan to be at the clinic for at least half a day.
Will it leave a scar?
All surgery leaves a scar. With a nasolabial flap, the cheek scar sits in the nasolabial fold, and the scars on the nose are planned along its natural borders.