Background: Lip cancer is the most frequent malignant neoplasm of the oral cavity. Defects larger than one-fourth of total upper lip length require reconstruction by established techniques or multiple procedures. Methods: The patient was a 53-year-old man who presented with a 1.5 cm basal cell carcinoma in the central upper lip. Two opposed vermillion flaps were designed and advanced following radical tumor excision to create a new skin-vermilion border. A rotational skin flap was prepared to maintain the normal aspect of the filter area. Results: The patient was evaluated 1 year after the operation. He showed well-healed flaps with excellent aesthetic and functional results of the filter area and Cupid’s bow. Conclusion: Within certain limits (maximum one-third of total upper lip length), double vermillion opposing flaps with a rotational skin flap appear to be a valid method for upper lip reconstruction.

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