Introduction: Nasolabial flaps have been recognised as versatile flaps for reconstruction of variety of defects in the face, nose, lip and the oral cavity. Random pattern inferiorly based nasolabial flaps (IBNLF) have been utilised for covering various small defects over the face and oral mucosa. This is also a reliable backup flap in partial failure of primary flaps in maxillofacial reconstruction. Aim:To evaluate the outcome of a secondary defect of commisure and buccal surface arising due to partial failure of bippadle PMMC flap with an inferiorly based nasolabial flap (IBNLF). The final functional and the esthetic result are evaluated, along with the need for subsequent secondary procedure. Case: A 73-year-old male presented with a rapidly growing Squamous cell carcinoma involving right cheek. En bloc resection of right oral commissure and buccal region was performed. Modified neck dissection was performed on the right side. Reconstruction of the defect was done using bipaddle PMMC flap. Partial failure of primary flap started from 5th post operative day. Complete defect of right commissure was evident by third week posteratively. Inferiorly based nasolabial flap (IBNLF) was used as a back up flap for correction of residual defect. Conclusion: An inferiorly based Nasolabial flap (IBNLF) is a reliable backup flap for the reconstruction of small and medium sized secondary defects in the face and oral cavity. This flap can be best utilized for elderly, high risk patients in whom neck dissection with facial artery ligation have been done
