Primary surgery of cleft lip and palate has dramatically improved with technical and material advances. Some adults who previously underwent surgery still have upper lip deformities or extensive scar, and they are occasionally seen for secondary treatment. We reported a case of unilateral cleft lip patient who had extensive scar involving the central 1/4 of the upper lip, with gross lip and nasal deformity. In this patient, we reconstructed the entire affected upper lip using an Abbe flap and an advancement flap from the lateral lip. This not only improved the upper lip contracture, but also moved the scar to the margin of the aesthetic unit. This removal of the visible scar from central portion of the lip provided a satisfactory aesthetic result. A large V-Y advancement flap from lateral upper lip has several advantages. These are sufficient soft tissue volume, inconspicuous scar in accordance with margin of aesthetic unit, and texture and color match. There is no previous report describes the application of V-Y advancement flap for secondary lip reconstruction of unilateral cleft lip deformity in the literature.