Combined Bilateral Hatchet and Nasolabial Advancement Flaps for a Large Defect of the Lower Lip

Abstract

A large full-thickness defect of the lower lip is difficult to reconstruct. Preservation of eating and speaking functions based on maintenance of oral sphincter and muscle function, sensation, and the oral aperture are the basic aims. It is also important to achieve a good aesthetic appearance. Here, we describe a new procedure using combined bilateral hatchet and nasolabial advancement flaps for a large full-thickness defect of the lower lip. The aim of use of the hatchet flap is to make a natural curve from the mentolabial fold to the mental protuberance using the "dog ear" resulting from suturing medially advanced bilateral hatchet flaps and to preserve a more certain blood supply to the medial edge of the flap. Our results indicate that the procedure using combined bilateral hatchet flaps and nasolabial flaps is useful for a U-shaped large full-thickness defect, with good functional and aesthetic outcomes.

Functional and Aesthetic Lower Lip Reconstruction Using the Yotsuyanagy Flap

“…[4][5][6][7][8] The goals of treatment are to restore normal lip anatomy, as well as oral movement and competence (maintaining maximum oral opening and sensitivity), to provide skin and mucosa coverage, to preserve lip dimension and prevent dental exposure allowing the use of dental prostheses, and, finally, to offer optimal aesthetic results always aiming for minimal sequelae. [9][10][11][12][13][14][15] To achieve those goals, a proper evaluation of the defect is mandatory; this evaluation must include size, location, depth, impaired function, and which anatomical subunits are involved. 9,16 Any lip reconstruction requires proper anatomy knowledge.…”