BACKGROUND: The upper lip is an important esthetic unit of the face and its reconstruction is a big challenge to the dermatosurgeon. OBJECTIVE: The aim of the paper is to present results of upper lip reconstruction for moderately sized defects with single island subcutaneously pedicled flaps, or in combination with additional local flaps. METHODS: Thirteen patients were operated upon mostly for malignant skin neoplasms. Defects of skin only were covered with island flaps planned individually to fit esthetic units of the face. Defects in skin and vermillion were covered with island flaps, and additionally and independently with flaps that reconstructed the vermilion. RESULTS: The healing process was in all the cases but one (partial flap necrosis) free of complications. Follow-up results were also very good functionally and esthetically.