A novel approach to columellar reconstruction in a child.

We present a novel method for columellar reconstruction using a hidden donor site and review the challenges and limitations of columellar reconstruction in children with Fitzpatrick VI skin type. A staged reconstruction was conceived in which a full-thickness skin graft was transferred to the superior gingivolabial sulcus in the area of the maxillary frenulum. Six months later, the prelaminated soft tissue flap was delivered through a horizontal incision at the subnasale, and the donor site closed primarily. We report satisfactory results following a novel approach to composite soft tissue reconstruction of the columellar subunit in a 9-year-old child. LEVEL OF EVIDENCE: 4 Laryngoscope, 128:2718-2720, 2018.