Upperlip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. Lip reconstruction home lip reconstruction all images on this website are the copyrighted property of their respective owners and may not be used without express permission from skin cancer and reconstructive surgery center. Griffin and coauthors analyzed larger upper lip skin defects repaired with vy advancement flap reconstruction to identify defect characteristics that might predict the need for revision surgery. A case report yuxing guo, md 1 chi mao, md1 1department of oral and maxillofacial surgery, peking university school and hospital of stomatology, beijing, china facial plast surg 2016. The camille bernard flap for lower lip reconstruction. Lips are also common sites for occurrence of skin cancers. The most common type of lip surgery is lip augmentation sometimes referred to as lip enhancement surgery. Reconstruction of the lower lip involved the rotation of a lateral area of the upper lip to the commissure. Giles fa gillies fan flap for lower lip reconstruction. Reconstruction of the lower lip journal of plastic, reconstructive. Patient reports that over the past 6 years the lesion has increased in size, has bled at intervals, and was not healing. Lip reconstruction connecticut stanislawmdstanislawmd. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive. The patient is a 61 year old man with a shave biopsy proven squamous cell carcinoma scc of the lower lip.
Any lesion that is present on the lip and enlarging could be a skin cancer, which needs to be investigated as soon as possible. Reconstruction of skin cancer defect by sam naficy, md, seattle plastic surgeon. The total lip defects resulted from tumor resection n6, trauma n3, and noma n1. The modified estlander flap is based more medially to the initially proposed flap and seeks to avoid lip commissure deformations. Is it possible to reconstruct a lip that has been damaged. Karapandzic flap and bernardburrowwebster flap for reconstruction of the lower lip 159 to 23 of the length of the lower lip. Karapandzic flap and bernardburrowwebster flap for. Lip reconstruction after tumor ablation world journal of plastic. Reconstruction of both the lips involving the commissure can be accomplished by means of primary. The camille bernard flap is probably the most popular of all cheek advancement methods for subtotal fullthickness lower lip reconstruction. General considerationsgeneral considerations for upper lip reconstruction, lower lip can be used, butfor upper lip reconstruction, lower lip can be used, but vice versa is avoided.
Defect of 30% of the upper or lower lip can be closeddefect of 30% of the upper or lower lip can be closed primarily great elasticity of. Rbcp total reconstruction of the lower lip with face flaps. Although, tobacco use has also been implicated in their formation. Outcomes following vy advancement flap reconstruction of. However, the functional reconstruction of fullthickness defects in the lower lip remains a challenge.
In oncologic lesions and hemangioma resections, the reconstruction is usually performed under the same anesthetic or after a short period needed for confirmation of completeness of cancer resection. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patients age, sex, occupation, and general health. It is important to adapt the reconstruction to the needs of the patient. Any patient who has suffered trauma to their lips, for example a dog bite or laceration, must be treated immediately.
Review of literature and description of a novel approach. Lip reconstruction surgery in these cases typically uses skin grafts. In this case, the lip reconstruction involved reconstruction of both the cutaneous and mucosal layers of the lip. It is certainly possible to remove and reconstruct a damaged portion of the lip. With bigger defects, the resulting microstomy limits the procedure. Aesthetic upper lip reconstruction with vermilion submucosalpedicle crosslip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized cutaneous amyloidosis occurring on the upper lip of a 48yearold man was surgically treated andaestheticallyreconstructed with. Lip tumors that produce lip defects are either congenital such as vascular malformations and hemangiomas. Use old photos, taken before your intial surgeries to communicate with your surgeon your aesthetic ideals but be prepared to have staged reconstruction. The new technique is an alternative for reconstruction of extensive upperlip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results. No flap failure was seen, and desirable function and esthetic results were obtained. Aesthetically, facial units should be reconstructed with adequate tissue match in terms of colour and texture, aiming at symmetry as well as preservation of the apparent. Lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. In this article, a new functional lower lip reconstruction technique that includes the transfer of a myocutaneous flap based on the mental neurovascular bundle and on the branches of the facial.
Lip reconstruction lip plastic surgery at the facial plastic surgery practice of dr. During this period, one patient who underwent reconstruction with a myomucosal flap and. Various plans of lip reconstruction with switched flaps the patient was returned to the operating room where the flaps were separated and wider excision was obtained from the lower lip. These flaps of skin are added to the injured lip to restore it. Upper lip reconstruction special considerations include presence of central structures cupids bow, philtrum in men, facial hair aids in hiding scars in men, nonhairbearing flaps brought into hearbearing areas can be noticeable the upper lip is less important in oral competence more lower lip tissue can be borrowed. Seven years ago, the patient underwent mohs surgery for the same diagnosis on the lower lip. We describe a case of squamous cell carcinoma of lower lip in a. Thus, the functional and aesthetic reconstruction of the lip has been described for centuries2. Total lower lip reconstruction using free neurotendinofasciocutaneous anterolateral thigh composite flap. There are many reasons why this may happen to an individual and whether your needs stem from a congenital or genetic defect, trauma, disease or cancer. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. Tellioglu10, in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free microsurgical flap from the. Advanced squamous cell carcinoma involving both upper and. Lips serve a vital role in cosmetic beauty of the face and are an important.
But there are other types of lip procedures as well. The aesthetic or functional abnormalities that prompted revision surgery and. A second surgery is necessary to reconstruct the commissure angle. There were concomitant chin and mandible defects in three and four patients. Lower lip reconstruction is more significant, because oral competence depends greatly on a functional lower lip having good muscular function, adequate height and sensation. Lip reconstruction may be required after trauma or surgical excision.
West of scotland regional plastic and oral surgery unit, canniesburn hospital, bearsden, glasgow. If there is a deep wound or hole in the lip, mucosa, or mucus membranes can also be used to fill in the area. Elliot duyboys and the team at associated plastic surgeons understand that there are often many emotions that accompany a disfigurement or loss of physical attributes. Reconstruction of lateral lower lip defects with transverse lip advancement flap. The reconstruction of fullthickness defects of the lower lip can be challenging because the integrity of mucosal, muscular, and cutaneous layers must be reestablished, and in this setting. Primary closure of the lip is the simplest technique for small. Address for correspondencechi mao, md, department of oral and. Lower lip reconstruction using the karapandzic technique scielo. Squamous cell carcinoma scc is the most common malignancy affecting the lip, unlike the rest of the facial skin where basal cell cancer is predominant. We present a case of lower lip carcinoma in which reconstruction was performed using a lateral tongue flap based on the tongue dorsum with a good outcome. Karapandzic flap find, read and cite all the research you need on.
Original article use of bernardwebster flap for lower lip. In all, 73 patients had total lower lip reconstruction and 14 patients accepted neartotal lower lip reconstruction 45 lower lip. Pdf on jan 23, 20, aditya sood and others published lower lip reconstruction. Reconstruction of the lip commissure with upper and lower. Cancers of the lower lip are most common and most often caused by sun exposure. Lip reconstruction list of high impact articles ppts.
Lip reconstruction is the process of maintaining oral competence, sufficient oral access and preservation of sensation after severe injury, burn or in case of lip cancer. Their role in aesthetic balance, facial expression, speech, and deglutination is not replicated by any other. The use of submental island flap for total lower lip. During the course of burn reconstruction, we often have to reconstruct the upper lip with tissue borrowed from the lower lip, a. Ower lip reconstruct ion s5 these clinical photographs illustrate well the use of this technique of lower lip reconstruction. Larrabee, jr, md procedure selection for surgical reconstruction of lip defects depends on the location and extent of the defect. We report the case of an advanced squamous cell carcinoma involving both the upper lip, lower lip, left oral commissure and buccal area and simultaneous reconstruction with local flap coverage that, to the best of our knowledge, has never been reported.
With total or subtotal lip defects, unlike the former technique, the bernardburrowwebster flap is a good option for reconstruction. This is more so when the resection is total and a complete lip has to be constructed. Depending on the size of the problem, lip deformities can usually be corrected in a very cosmetic fashion so that residual signs of the reconstruction are minimal. Technique for the reconstruction of oral commissure. Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively. Pdf lip reconstruction poses a particular challenge to the plastic surgeon in that the lips are the dynamic center of the lower third of the face find, read and. Reconstruction can be very effective for small defects. The muscles must be carefully repaired to avoid numbness in the lip. The most common reason for creation of a lip defect is to remove a lip cancer.
The loss of lip competence can interfere with articulation, whistling, kissing, and the containment of salivary secretions. Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction. In addition, it can restore lip volume without any difficulties. No gold standard in the reconstruction of both upper and lower lips has been established. Reconstruction of the lip commissure with upper and lower lip fullthickness defects using submental and nasolabial flaps.
If the defect is larger than this, a free flap is used for reconstruction. Patients usually present for lip reconstruction immediately following lip loss. Functional and cosmetic considerations must be included in any lip or chin reconstruction. In trauma, the reconstruction is also performed immediately after. Total reconstruction of the upper lip using bilateral. Any reconstruction of the lips must include both functional and cosmetic considerations. Basal cell cancers typically occur on the upper lip whereas squamous cell cancers occur on the lower lip. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer. There are many conditions that could benefit from a lip reconstruction such as trauma, congenital deformities, removal of cancerous lesions, or paralysis of facial nerve.
Reconstructed lower lip 3 months postoperative i in modified fig. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. Lower lip reconstruction strategies patient had a lesion covering 90% of the lower lip that was reconstructed using the websterbernard technique and a tongue flap figure 7, table 1. In this chapter, we focus on the surgical reconstruction strategies for acquired deformities commonly seen after cancer resections. Lip reconstruction poses a particular challenge to the plastic surgeon in that the lips are the dynamic center of the lower third of the face. The mental vy advancement flap is a useful reconstruction method for the cutaneous lower lip. Use of bernardwebster flap for lower lip reconstruction after excision of squamous cell carcinoma. We present a case of lip reconstruction following a total resection of the upper lip. The use of submental island flap for total lower lip reconstruction. Lower lip carcinoma reconstruction using abbe estlander flap. An elderly male patient presented with a malignant lesion over the lower lip which required surgical excision of. Even small abnormalities can be apparent because of the prominent location on the face. Lip reconstruction can generate a considerable challenge to the plastic surgeon in that the lips are the primary aesthetic and dynamic center of.
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