A 65-year-old woman with a deeply infiltrating basal cell carcinoma in the right ala underwent full-thickness excision of most of the ala, including the alar rim, crease, and the adjacent cheek, leaving a 'through-and-through' defect. Reconstruction was performed by using the reverse nasolabial flap and a cartilage graft across the alar defect, harvested from the concha, to prevent nostril collapse and to maintain the alar shape. The reverse or turnover nasolabial flap is a variant of the conventional nasolabial flap; however, it may be more suited for the repair of a full-thickness, lateral alar defect. The reverse nasolabial flap functions both as an inner liner and an outer cover and the repair is performed as a single-stage procedure. Furthermore, this flap can provide both excellent function and excellent cosmetic outcome.

Skin aging occurs by both intrinsic and extrinsic factors as we age. Intrinsic aging is an inevitable process which results in thin, dry, and wrinkled skin, while extrinsic aging is caused by environmental factors such as sun exposure, smoking, and air pollution. [1][2][3] Skin wrinkles, loss of elasticity, and skin roughness are the representative features of skin aging. Skin aging can be quantitatively evaluated by visual evaluation, 4-6 non-invasive measurement devices, [7][8][9] and molecular biological analysis. [10][11][12]