Reconstruction of columellar defects continues to be a surgical challenge. We present the results of two child-abuse patients who were successfully treated with a technique in which medially based bilateral horizontal nasolabial flaps were used to reconstruct total columellar loss. Our technique provides adequate tissue with minimal cosmetic deformity. It also obviates the need for multiple staged procedures. We recommend the use of this method for repair of either partial or total columellar defects secondary to trauma or infection.