Nasolabial Flap in Nasal Reconstruction: A Comprehensive Review

The nasolabial flap (NLF) is one of the most versatile and frequently employed local flaps in nasal reconstruction, offering excellent tissue compatibility, reliable vascular supply, and the ability to conceal donor-site scars within the natural nasolabial crease. This review provides plastic surgery residents with a comprehensive and clinically applicable overview of the NLF, covering its anatomical basis, classification, indications, surgical technique, and outcomes in the context of nasal reconstruction following excision of non-melanoma skin cancers (NMSCs). We synthesize current evidence from retrospective series, case reports, and systematic reviews to address how defect location, size, and depth influence flap selection, and to compare the NLF against alternative approaches such as the paramedian forehead flap and skin grafts. The facial subunit principle a fundamental framework in preoperative planning is reviewed in detail. Emphasis is placed on technical pearls and perioperative decision-making relevant to the resident's learning trajectory. Complications, their prevention, and management are also discussed. The available evidence supports the NLF as a first-line reconstructive option for mild-to-moderate nasal defects, with outcomes comparable or superior to more complex procedures in appropriately.