Functional reconstruction of the upper and lower lips and commissure with a forearm flap combined with a free gracilis muscle transfer

Ueda, Kazuki; Oba, Sosuke; Nakai, Kunihiro; Okada, Masashi; Kurokawa, Norifumi; Nuri, Takashi

doi:10.1016/j.bjps.2008.01.040

Cited by 40 publications

(29 citation statements)

References 9 publications

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“…The functional outcome of these reconstructive approaches with muscle transfer has not been rigorously evaluated, and therefore, donor site morbidity is inevitable. [22][23][24][25][26][27][28] Cosmetic defects remain a long-term problem, particularly in female patients.…”

Section: Discussionmentioning

confidence: 99%

Treatment and Long-Term Follow-Up of Oral Cancer Postoperative Sialorrhea With Dermal Sling Operation

Hsieh

Horng

et al. 2015

Annals of Plastic Surgery

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Section: Discussionmentioning

confidence: 99%

Treatment and Long-Term Follow-Up of Oral Cancer Postoperative Sialorrhea With Dermal Sling Operation

Hsieh

Horng

et al. 2015

Annals of Plastic Surgery

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“…There are few reports of reconstructing complete lip defects in the literature. 4,7,8 For repairing partial lip defects, a free RFA flap 5,6,9 has been the most frequently reported. It has the advantage of a good blood supply, but only a straight axial vessel is acquirable, which does not provide adequate coverage of the upper and lower lips.…”

Section: Discussionmentioning

confidence: 99%

“…It has the advantage of a good blood supply, but only a straight axial vessel is acquirable, which does not provide adequate coverage of the upper and lower lips. Either a free RFA flap-a chimeric flap using the palmaris longus tendon with the brachioradialis muscle 7 -or a free RFA flap combined with a free gracilis muscle flap 8 can be applied to upper and lower lip defects simultaneously. Either offers a good blood supply, a functioning neo-sphincter, and return of sensation.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report

et al. 2011

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It is difficult to totally reconstruct the lips and achieve good functional and aesthetic results, such as oral sphincter function, sensation, appearance, color, and movement. There have been few reports of reconstructing complete lip defects. We present a case of completely reconstructing the lip defects of a 55-year-old patient who had verrucous carcinoma of the buccal mucosa and lips. Extensive ablation was performed by wide bilateral excision of the buccal mucosa and marginal resection of the anterior mandible and both lips. The tongue, partial tongue base mucosa, and retromolar trigone were preserved. To reconstruct and resurface the intraoral and lip defects nearly totally, we applied a free anterolateral thigh (ALT) flap in chimeric style with two independent sets of perforators and skin islands. To achieve better oral function and cosmetics, revisions of the ALT flap, full-thickness scrotal skin grafting, autologous fat grafting, and skin tattooing were done in stages. Postoperative oral sphincter function was obtained without drooling; the general appearance of the lips was also acceptable.

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“…6 7 Since 2000, a few authors reported lower lip reconstruction with gracilis free flap harvested without the overlying skin paddle, and most of them used a combination with other free flaps for big facial injuries, but important donor-site morbidity was observed. 8 Afterwards, Lengelé et al reported a prefabricated gracilis muscle free flap for a lower lip reconstruction, but a second surgical step was needed and scar contraction led to a loss of 25% of vestibular depth. 9 The use of gracilis muscle to reconstruct lower lip defects has gained popularity since the study conducted by Ninkovic et al in 2007 4 : they used the gracilis flap arranged with the facial artery musculomucosal flap for the mucosa restoration and used a skin graft harvested from the scalp for external skin.…”

Section: Discussionmentioning

confidence: 99%

Lower Lip and Chin Reconstruction with Functional Myocutaneous Gracilis Flap

Spaggiari

Benanti

Starnoni

et al. 2019

Indian J Plast Surg

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Lower lip is an important anatomical unit in daily life activities, and its proper functional and aesthetic reconstruction is crucial. In the literature, both locoregional and microsurgical flaps have been described in lower lip reconstruction. Few authors have reported lower lip reconstruction with gracilis free flap. We describe a case of wide lower lip and chin avulsion caused by human bite reconstructed with an innervated gracilis free flap raised with its overlying skin paddle. The gracilis flap was harvested with a skin paddle of 7 × 5 cm, and vascular and nervous anastomoses were performed. At 9-month follow-up, an electromyography showed high muscle activities observed in the central part of the flap, and the patient achieved good oral functions reported with daily life activities. Raising the flap with the overlying skin paddle allowed us to avoid morbidity in other donor sites, avoid scar retraction of the skin graft on the gracilis that could limit its movement, and plan aesthetical refinements such as hair transplantation or tattoo of the beard on the skin.

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Functional reconstruction of the upper and lower lips and commissure with a forearm flap combined with a free gracilis muscle transfer

Cited by 40 publications

References 9 publications

Treatment and Long-Term Follow-Up of Oral Cancer Postoperative Sialorrhea With Dermal Sling Operation

Treatment and Long-Term Follow-Up of Oral Cancer Postoperative Sialorrhea With Dermal Sling Operation

Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report

Lower Lip and Chin Reconstruction with Functional Myocutaneous Gracilis Flap

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