Background: Skin cancer of the nasal tip is frequent, and reconstruction after Mohs surgery might be challenging. The rotation flap is a very commonly used flap for reconstructions on the vertex and the extremities but rarely on the nose. In textbooks rotation flaps in nose reconstruction are rarely mentioned. Objective: We present a rotation flap from the caudal tip and the columella of the nose for defects of the lateral tip of the nose. Methods: With graphics and photographs of case studies we explain the mechanism of placement and movement of the flap. Results: The rotation flap is useful for reconstructions of medium-size defects of the distal lateral nose tip. Conclusion: The rotation flap can be used in the reconstruction of laterally placed nasal tip defects. As this flap is not mentioned in textbooks for nasal tip reconstruction, its value for this localization is probably underestimated.