Keeping in mind the direction of the relaxed skin tension lines (RSTL), we used a local W-plastic rotation skin flap from the cheek to cover a large nasal defect resulting from the excision of a benign skin lesion. This technique, first described by Imre [7], is superior to the direct single-pedicle advancement flap from the cheek, or to any nasolabial flap, for repair of such nasal defects.