Introduction: Gunshot wounds commonly result in extensive tissue damage with disruption of soft tissue. Immediate treatment under difficult conditions on site often leads to poor clinical outcome. Case report: We report on a 81-year-old patient who suffered from a shell-splinter injury during the Second World War in 1944. On clinical inspection cicatrices in the left nasolabial groove, the chin and the left side of the neck were observed. Moreover, an unincisive vermilion of the lower lip and high tonicity of the face muscles was noticed. The intraoral tegument in the lower jaw was reconstructed by means of a split-thickness skin graft from the abdominal wall. Radiography did not reveal any metallic fragments or defects of the bone. This case report focuses on soft tissue reconstruction as estimated on the basis of scars. Discussion: Local flaps provide good aesthetic and functional results after facial skin reconstructions. Alternatively, skin microsurgery grafts and skin extension closures may serve as surgical procedures for contraindications of local flaps.