Hemangiomas are proliferative lesions characterized by increased endothelial cell turnover. Lip hemangiomas can distort lip anatomy and are at increased risk of ulceration and/or bleeding, which lead to impaired function and disfigurement. Surgery can provide active treatment but it can be problematic because vermilion tissue is unique and not found elsewhere on the body. Since there is no similar tissue that can easily be used for reconstructing missing vermilion, its preservation is essential for a satisfactory cosmetic result. We present the case of a 74 year old woman suffering from a large hemangioma of the mid-face and particulary with an angiomatous ulcerated lesion at the level of the lower lip. We describe clinical management and surgical treatment of this pathology.