Introduction: The reconstruction of full-thickness alar wounds often requires multiple 
challenging surgical procedures. These procedures, although often functionally and 
aesthetically successful, are often staged, and they therefore introduce operative risks, 
significant investments of surgeon and patient time, and extraordinary costs. Aim of the 
work: to evaluate the use of the folded nasolabial flap for reconstruction of nasal alar full 
thickness defects. Patients and methods: Ten patients had post-ablative or post-traumatic 
nasal alar full thickness defects included in this study for surgical reconstruction by folded 
nasolabial flap. Patients were admitted to The Plastic Surgery department of Minia University 
Hospital from October 2018 till June 2019. The flap designed as a superiorly based nasolabial 
flap immediately, after flap elevation primary thinning was done and the distal end of the flap 
folded upon itself. The flap donor site was primarily closed. Results: This procedure was 
successful in 9 patients by complete survival of the flaps without evidence of necrosis or 
narrowing of airways, Only one case had bulky flap and alar retraction and needed redo by 
flap debulking and septal cartilage graft insertion. Conclusion: In distinction to the multiple 
operative procedures required to replace the missing tissues of the ala, this folded nasolabial 
flap offers a single-stage alar reconstruction.