CC BY-NC 4.0 · Arch Plast Surg 2016; 43(01): 19-25
DOI: 10.5999/aps.2016.43.1.19
Original Article

Outcomes of Surgical Treatment of Vascular Anomalies on the Vermilion

Sang Min Park
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
,
Yong Chan Bae
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
,
Jae Woo Lee
Department of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea
,
Hoon Soo Kim
Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
,
In Sook Lee
Department of Radiology, Pusan National University School of Medicine, Busan, Korea
› Author Affiliations
This work was supported by a clinical research grant from Pusan National University Hospital in 2015.

Background The vermilion plays an important role in both the aesthetic and functional aspects of facial anatomy. Due to its structural features, the complete excision of vascular anomalies on the vermilion is challenging, making it difficult to determine the appropriate treatment strategy. Thus, the authors analyzed the results of surgical treatment of vascular anomalies on the vermilion.

Methods The medical records of 38 patients with vascular anomalies on the vermilion who underwent surgery from 1995 to 2013 were analyzed. Nine of the cases had an involuted hemangioma, and 29 cases had a vascular malformation; of the vascular malformations, 13, 11, one, and four cases involved were capillary malformations (CMs), venous malformations (VMs), lymphatic malformations (LMs), and arteriovenous malformations (AVMs), respectively. We investigated the surgical methods used to treat these patients, the quantity of surgical procedures, complications and instances of recurrence, and self-assessed satisfaction scores.

Results A total of 50 operations were carried out: 28 horizontal partial excisions, eight vertical partial excisions, and 14 operations using other surgical methods. All cases of AVM underwent complete excision. Six cases experienced minor complications and one case of recurrence was observed. The overall average satisfaction score was 4.1 out of 5, while the satisfaction scores associated with each lesion type were 4.2 for hemangiomas, 3.9 for CMs, 4.2 for VMs, 5.0 for LMs, and 4.0 for AVMs.

Conclusions It is difficult to completely excise vascular anomalies that involve the vermilion. This study suggests that partial excision focused on correcting the overall contour of the lips is effective and leads to satisfactory results.

The content of this article was presented at the 72nd Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 7–9, 2014 in Seoul, Korea.




Publication History

Received: 15 April 2015

Accepted: 01 September 2015

Article published online:
20 April 2022

© 2016. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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  • References

  • 1 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69: 412-422
  • 2 Jackson IT, Carreno R, Potparic Z. et al. Hemangiomas, vascular malformations, and lymphovenous malformations: classification and methods of treatment. Plast Reconstr Surg 1993; 91: 1216-1230
  • 3 Enjolras O, Mulliken JB. Vascular tumors and vascular malformations (new issues). Adv Dermatol 1997; 13: 375-423
  • 4 Chim H, Drolet B, Duffy K. et al. Vascular anomalies and lymphedema. Plast Reconstr Surg 2010; 126: 55e-69e
  • 5 Neligan P. Plastic surgery. New York: Elsevier Saunders; 2013
  • 6 Arneja JS, Gosain AK. Vascular malformations. Plast Reconstr Surg 2008; 121: 195e-206e
  • 7 Greene AK. Management of hemangiomas and other vascular tumors. Clin Plast Surg 2011; 38: 45-63
  • 8 Spring MA, Bentz ML. Cutaneous vascular lesions. Clin Plast Surg 2005; 32: 171-186
  • 9 Elluru RG. Cutaneous vascular lesions. Facial Plast Surg Clin North Am 2013; 21: 111-126
  • 10 Stier MF, Glick SA, Hirsch RJ. Laser treatment of pediatric vascular lesions: Port wine stains and hemangiomas. J Am Acad Dermatol 2008; 58: 261-285
  • 11 Hennedige AA, Quaba AA, Al-Nakib K. Sturge-Weber syndrome and dermatomal facial port-wine stains: incidence, association with glaucoma, and pulsed tunable dye laser treatment effectiveness. Plast Reconstr Surg 2008; 121: 1173-1180
  • 12 Kim Y, Oh SJ, Lee J. et al. Surgical treatment of dermatomal capillary malformations in the adult face. Arch Plast Surg 2012; 39: 126-129
  • 13 Sun ZJ, Zhang L, Zhang WF. et al. Epithelioid hemangioma in the oral mucosa: a clinicopathological study of seven cases and review of the literature. Oral Oncol 2006; 42: 441-447
  • 14 Visser A, FitzJohn T, Tan ST. Surgical management of arteriovenous malformation. J Plast Reconstr Aesthet Surg 2011; 64: 283-291
  • 15 Barrett AW, Speight PM. Superficial arteriovenous hemangioma of the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90: 731-738
  • 16 Smith MC, Zimmerman MB, Burke DK. et al. Efficacy and safety of OK-432 immunotherapy of lymphatic malformations. Laryngoscope 2009; 119: 107-115
  • 17 Kulungowski AM, Fishman SJ. Management of combined vascular malformations. Clin Plast Surg 2011; 38: 107-120
  • 18 Steiner F, FitzJohn T, Tan ST. Surgical treatment for venous malformation. J Plast Reconstr Aesthet Surg 2013; 66: 1741-1749
  • 19 Lin XX, Wang W, Wu SF. et al. Treatment of capillary vascular malformation (port-wine stains) with photochemotherapy. Plast Reconstr Surg 1997; 99: 1826-1830