Facial skin cancers

Alar lesion: Banner flap or V-Y from mouth skin crease

Lip lesions
1/4 to 1/3 of upper lip can be excised and closed primarily

Abbe Estlander flap (see diagram)
Up to 1/4 of upper lip can be used to close defect of lower lip. Donor flap width is half width of base of surgical defect. Flap is pedicled on vermillion border with small cuff of muscle preserving the labial artery

Upper nose: Glabellar flap (see photo)
blood supply on supratrochlear artery
Ensure tension free to avoid distortion of medial canthus

Alar:Nasolabial flap: for lateral nose or ala. Can design with an inferior or superior base. Can use for full thickness ala defects if turn edge in and de-epithelialise

Wedge excision and primary closure of ear: Adequate resection involves full thickness of skin and cartilage. Need to excise posterior skin to avoid buckling. Can resect up to 1/3 of vertical height of ear (see photo)