Subscribe to RSS
DOI: 10.1055/s-0044-1792107
Lip Reconstruction
Funding None.Abstract
Lip reconstruction is challenging for plastic surgeons due to the unique functionality and aesthetic complexity of the lips within the lower third of the face. The etiology of lip defects varies from congenital to acquired causes of origin. The most common acquired cause of lip defects is resection of malignancy. Defects can present as various shapes and sizes and may affect any location on the lip. Each defect requires a full workup, and algorithms such as the rule of thirds, are commonly used to swiftly identify optimal reconstructive options. The goal of lip reconstruction is to ensure oral competence while restoring intricate, cutaneous landmarks. The approach to lip reconstruction makes use of many rungs of the reconstructive ladder. This article primarily focuses on repairing lip defects secondary to Mohs surgery; however, the reconstructive methods discussed are useful for lip defects of all causes. This article will review lip defect evaluation, reconstructive methods, common complications, and adjuvant therapies to ensure optimal lip function and cosmesis.
Keywords
lip reconstruction - Abbe flap - Bernard–Burow - Estlander flap - Karapandzic flap - Mohs surgeryConclusion
None declared.
Publication History
Article published online:
17 December 2024
© 2024. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Ding A. The ideal lips: lessons learnt from the literature. Aesthetic Plast Surg 2021; 45 (04) 1520-1530
- 2 Vyas T, Gupta P, Kumar S, Gupta R, Gupta T, Singh HP. Cleft of lip and palate: a review. J Family Med Prim Care 2020; 9 (06) 2621-2625
- 3 Sanniec KJ, Carboy JA, Thornton JF. Simplifying lip reconstruction: an algorithmic approach. Semin Plast Surg 2018; 32 (02) 69-74
- 4 Piccinin MA, Zito PM. Anatomy, Head and Neck, Lips. Treasure Island, FL: StatPearls Publishing; 2024
- 5 Groeger S, Meyle J. Oral mucosal epithelial cells. Front Immunol 2019; 10: 208
- 6 Stuzin JM. Protecting the marginal and cervical branches of the facial nerve. In: Rohrich RJ, Stuzin JM, Dayan E, Ross EV. eds. Facial Danger Zones: Staying Safe with Surgery, Fillers, and Non-Invasive Devices. Stuttgart: Thieme Verlag; 2020
- 7 Baumann D, Robb G. Lip reconstruction. Semin Plast Surg 2008; 22 (04) 269-280
- 8 Dadhich A, Shah S, Nilesh K. et al. Reconstruction of acquired lip defects: ten-year experience at a tertiary care center. J Oral Biol Craniofac Res 2020; 10 (04) 698-704
- 9 SEER. Cancer of the lip: cancer stat facts. Accessed June 6, 2024 at: https://seer.cancer.gov/statfacts/html/lip.html
- 10 Moretti A, Vitullo F, Augurio A, Pacella A, Croce A. Surgical management of lip cancer. Acta Otorhinolaryngol Ital 2011; 31 (01) 5-10
- 11 Kraus DH, Carew JF, Harrison LB. Regional lymph node metastasis from cutaneous squamous cell carcinoma. Arch Otolaryngol Head Neck Surg 1998; 124 (05) 582-587
- 12 Mullen JT, Feng L, Xing Y. et al. Invasive squamous cell carcinoma of the skin: defining a high-risk group. Ann Surg Oncol 2006; 13 (07) 902-909
- 13 Rowe DE, Carroll RJ, Day Jr CL. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol 1992; 26 (06) 976-990
- 14 Quazi SJ, Aslam N, Saleem H, Rahman J, Khan S. Surgical margin of excision in basal cell carcinoma: a systematic review of literature. Cureus 2020; 12 (07) e9211
- 15 Hong JH, Jung CW, Kim HS, Bae YC. Appropriate surgical margins for excision of squamous cell carcinoma of the lower lip. Arch Plast Surg 2023; 50 (04) 377-383
- 16 See MS, Morritt AN, Jallali N. Lip reconstruction. In: Farhadieh RD, Bulstrode NW, Cugno S. eds. Plastic and Reconstructive Surgery: Approaches and Techniques. Hoboken, NJ: John Wiley & Sons, Ltd; 2015: 377-389
- 17 Raschke GF, Rieger UM, Bader RD, Schultze-Mosgau S. Lip reconstruction: an anthropometric and functional analysis of surgical outcomes. Int J Oral Maxillofac Implants 2012; 41 (06) 744-750
- 18 Madorsky S, Meltzer O. Myomucosal lip island flap for reconstruction of small to medium lower lip defects. Facial Plast Surg Aesthet Med 2020; 22 (03) 200-206
- 19 Kolhe PS, Leonard AG. Reconstruction of the vermilion after “lip-shave.”. Br J Plast Surg 1988; 41 (01) 68-73
- 20 Soliman S, Hatef DA, Hollier Jr LH, Thornton JF. The rationale for direct linear closure of facial Mohs' defects. Plast Reconstr Surg 2011; 127 (01) 142-149
- 21 Kermer C, Millesi W, Paternostro T, Nuhr M. Muscle-nerve-muscle neurotization of the orbicularis oris muscle. J Craniomaxillofac Surg 2001; 29 (05) 302-306
- 22 Barry RBM, McKenzie J, Berg D, Langtry JA. Direct primary closure without undermining in the repair of vermilionectomy defects of the lower lip. Br J Dermatol 2012; 167 (05) 1092-1097
- 23 Burget GC, Menick FJ. Aesthetic restoration of one-half the upper lip. Plast Reconstr Surg 1986; 78 (05) 583-593
- 24 Housman TS, Berg D, Most SP, Odland PB, Stoddard E. Repair of the philtrum: an illustrative case series. J Cutan Med Surg 2008; 12 (06) 288-294
- 25 Fernández-Casado A, Toll A, Pujol RM. Reconstruction of defects in paramedian upper lip. Dermatol Surg 2009; 35 (10) 1541-1544
- 26 Sanniec K, Harirah M, Thornton JF. Lip reconstruction after Mohs cancer excision: lessons learned from 615 consecutive cases. Plast Reconstr Surg 2020; 145 (02) 533-542
- 27 Seavolt MB, McCall MW. Repair of partial-thickness Mohs defects of the vermilion lip with a combination of full-thickness graft and mucosal advancement. Dermatol Surg 2005; 31 (10) 1333-1335
- 28 Gloster Jr HM. The use of second-intention healing for partial-thickness Mohs defects involving the vermilion and/or mucosal surfaces of the lip. J Am Acad Dermatol 2002; 47 (06) 893-897
- 29 Leonard AL, Hanke CW. Second intention healing for intermediate and large postsurgical defects of the lip. J Am Acad Dermatol 2007; 57 (05) 832-835
- 30 Sahai R, Singh S, Singh AK. A novel technique of reconstruction of vermilion by pedicled myomucosal labial vestibular flap in traumatic defect of lower lip. Natl J Maxillofac Surg 2022; 13 (01) 125-129
- 31 Zide MF, Fuselier C. The partial-thickness cross-lip flap for correction of postoncologic surgical defects. J Oral Maxillofac Surg 2001; 59 (10) 1147-1153
- 32 Fatani B, Alhilal AI, Alzahrani HH, Alkhattabi RR, Alhindi M. Facial reconstruction using facial artery myomucosal flap: a comprehensive review. Cureus 2023; 15 (07) e42060
- 33 Akali NR, Jaya AC, Balasubramanian D, Iyer S, Thankappan K. Islanded facial artery musculo-mucosal flap for partial pharyngeal defect reconstruction after total laryngectomy: case report. Head Neck 2021; 43 (01) E1-E6
- 34 Mrad MA, AlMarshad FA, AlMarghoub MA, Mahabbat N, AlMubarak SK. Tongue flap for total full thickness upper lip with vermillion reconstruction: case report. Plast Reconstr Surg Glob Open 2022; 10 (02) e4135
- 35 Goldenberg DC, Ferreira MVC, Moura T, Gemperli R. Use of the tongue tip flap for lower lip reconstruction in involuted hemangioma. J Vasc Anomalies (Phila) 2021; 2 (01) e004
- 36 Kim JH, Ahn CH, Kim S, Lee WS, Oh SH. Effective method for reconstruction of remaining lower lip vermilion defect after a mental V-Y advancement flap. Arch Craniofac Surg 2019; 20 (02) 76-83
- 37 Salgarelli AC, Sartorelli F, Cangiano A, Collini M. Treatment of lower lip cancer: an experience of 48 cases. Int J Oral Maxillofac Surg 2005; 34 (01) 27-32
- 38 Spira M, Stal S. V-Y advancement of a subcutaneous pedicle in vermilion lip reconstruction. Plast Reconstr Surg 1983; 72 (04) 562-564
- 39 Karapandzic M. Reconstruction of lip defects by local arterial flaps. Br J Plast Surg 1974; 27 (01) 93-97
- 40 Miller LE, Greene JJ. The Karapandzic flap. Oper Tech Otolaryngol Head Neck Surg 2020; 31 (01) 21-25
- 41 Becker S, Lee MR, Thornton JF. Ergotrid flap: a local flap for cutaneous defects of the upper lateral lip. Plast Reconstr Surg 2011; 128 (05) 460e-464e
- 42 Zhang Y, Wu HL, Lu YM. Contralateral nasolabial flap for reconstruction of midface defects. Aesthetic Plast Surg 2012; 36 (05) 1175-1178
- 43 Coutinho I, Ramos L, Gameiro AR, Vieira R, Figueiredo A. Lower lip reconstruction with nasolabial flap: going back to basics. An Bras Dermatol 2015; 90 (3, suppl 1): 206-208
- 44 Hagan WE, Walker LB. The nasolabial musculocutaneous flap: clinical and anatomical correlations. Laryngoscope 1988; 98 (03) 341-346
- 45 Correia Duarte M, Nikkhah D, Kang N. The neurotised Estlander flap for lip reconstruction. JPRAS Open 2020; 27: 63-65
- 46 D L Brougham N, Adams BM. D. L. Brougham N. A modification of the Webster-Bernard lip reconstruction. Plast Reconstr Surg Glob Open 2020; 8 (04) e2762
- 47 Langstein HN, Robb GL. Lip and perioral reconstruction. Clin Plast Surg 2005; 32 (03) 431-445 , viii
- 48 Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Total lower lip reconstruction with a composite radial forearm-palmaris longus tendon flap: a clinical series. Plast Reconstr Surg 2004; 113 (01) 19-23
- 49 Sadove RC, Luce EA, McGrath PC. Reconstruction of the lower lip and chin with the composite radial forearm-palmaris longus free flap. Plast Reconstr Surg 1991; 88 (02) 209-214
- 50 de Witt CA, de Bree R, Verdonck-de Leeuw IM, Quak JJ, Leemans CR. Donor site morbidity of the fasciocutaneous radial forearm flap: what does the patient really bother?. Eur Arch Otorhinolaryngol 2007; 264 (08) 929-934
- 51 Yildirim S, Gideroğlu K, Aydogdu E, Avci G, Akan M, Aköz T. Composite anterolateral thigh-fascia lata flap: a good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction. Plast Reconstr Surg 2006; 117 (06) 2033-2041
- 52 Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Reconstruction of extensive composite mandibular defects with large lip involvement by using double free flaps and fascia lata grafts for oral sphincters. Plast Reconstr Surg 2005; 115 (07) 1830-1836
- 53 Tsuge I, Yamanaka H, Katsube M, Sowa Y, Sakamoto M, Morimoto N. Lower lip reconstruction using a sensory anterolateral thigh flap as the first choice. Plast Reconstr Surg Glob Open 2023; 11 (05) e5003
- 54 Sasidaran R, Zain MAM, Basiron NH. Lip and oral commissure reconstruction with the radial forearm flap. Natl J Maxillofac Surg 2012; 3 (01) 21-24
- 55 Yamauchi M, Yotsuyanagi T, Yokoi K, Urushidate S, Yamashita K, Higuma Y. One-stage reconstruction of a large defect of the lower lip and oral commissure. Br J Plast Surg 2005; 58 (05) 614-618
- 56 Sarrami SM, Skochdopole AJ, Ferry AM, Buchanan EP, Hollier Jr. LH, Dempsey RF. Revisional techniques for secondary cleft lip deformities. Semin Plast Surg 2021; 35 (02) 65-71
- 57 Gold MH, Foster TD, Adair MA, Burlison K, Lewis T. Prevention of hypertrophic scars and keloids by the prophylactic use of topical silicone gel sheets following a surgical procedure in an office setting. Dermatol Surg 2001; 27 (07) 641-644
- 58 Momeni M, Hafezi F, Rahbar H, Karimi H. Effects of silicone gel on burn scars. Burns 2009; 35 (01) 70-74
- 59 Kim JC, Hadlock T, Varvares MA, Cheney ML. Hair-bearing temporoparietal fascial flap reconstruction of upper lip and scalp defects. Arch Facial Plast Surg 2001; 3 (03) 170-177
- 60 Brown C, Watson D. Lip augmentation utilizing allogenic acellular dermal graft. Facial Plast Surg 2011; 27 (06) 550-554