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Background. Reconstruction of defects of the distal nose/columella region present a challenge both esthetically and functionally.Objective. To describe the use of nasal floor tissue as an inferiorly based transposition flap for closure of distal nose/columella defects.Methods. Mohs micrographic surgery for excision of basal cell carcinoma was performed on the distal nose/columella area of a patient. The resultant defect was closed using an inferiorly based transposition flap elevated from the nasal floor. Other closure options for this region are discussed.Conclusion. The nasal floor flap allowed the reconstruction of a properly contoured columella and distal nose.