Flap design challenges for upper lip defect: a case series.

Basal cell carcinoma (BCC) of the upper lip poses significant reconstructive challenges due to the need to restore both function and aesthetics in a highly visible area. This case series presents four patients with upper lip BCC that underwent Mohs micrographic surgery followed by individualized local flap reconstruction. Flap selection was tailored to each defect, utilizing rotational, advancement, O-to-Z, and transpositional flaps to address variations in size, location, and tissue availability. All patients experienced satisfactory healing, restoration of lip contour, and preservation of oral competence, with no major complications or recurrences during follow-up. These results highlight the importance of careful preoperative planning and personalized surgical approaches in achieving optimal outcomes for upper lip reconstruction. Our findings support the use of versatile local flaps as effective options for managing complex upper lip defects following BCC excision.