18-year-old patient who 5 months earlier had been the victim of a severe 13,800 volt electrical burn to the face while trying to save a co-worker. He presented an extensive injury with loss of both lips and nose. Extensive scarring of the perioral and adjacent areas made it impossible to use any type of local flap for reconstruction of the area. In the nasal region there was loss of skin substance and nasal lining, as well as part of the cartilaginous covering of the dorsum, tip, tail and nasal wings. He had undergone surgical reconstruction with a frontal flap 4 months earlier in another department, but this had progressed to necrosis.

Reconstruction was scheduled using a bipedicled flap from the anterior cervical region, described by Tsur (3), for lip reconstruction and a right supratrochlear flap for reconstruction of the nasal lining and a left supratrochlear flap for nasal coverage.
There was a partial loss of the left supratrochlear coverage flap and a small partial loss of the right supratrochlear flap for the nasal lining, which were observed at 3 days postoperatively. On the fifteenth day, one of the cervical flap pedicles was released and on the 30th day, the other was released after complete integration of the flap to the upper lip. Thereafter, several flaps were performed under local anaesthesia, every 2 months, for the reconstruction of the lower lip, the tailbone and the nasal tip, and thinning by defatting of the main flaps was also performed. A total of 7 complementary procedures were performed.
Persistent residual oedema of the cervical flap, keloids and hypertrophic scars appeared in the donor areas, which were treated with intralesional corticosteroids.
The final reconstruction, 2 years after the Tsur flap was made, made it possible to create an emotionally expressive structure although with limited functionality; touch-ups and refinements improved the final result, achieving a satisfactory aesthetic appearance and food continence, which sufficiently pleased the patient.
At present, 4 years after the initial surgery, no further surgical treatments have been scheduled.