Reconstruction of Defects Involving the Lip and Chin

A Bipedicled Lip Switch Flap From the Upper Lip for Delayed Re-Do Total Lower Lip Reconstruction: A Case Report

“…Full-thickness flaps are advanced by utilizing triangular excisions taken from soft tissues of the cheeks along the bilateral nasolabial folds referred to as Burow’s triangles. 14,15 Webster 16 modified this technique to include mucosal triangles excised from bilateral submental areas to allow formation of a new vermilion to the reconstructed lip. This initial reconstruction failed in our patient because it did not adequately restore the vermilion defect of her lower lip.…”

Functional and Aesthetic Lower Lip Reconstruction Using the Yotsuyanagy Flap

“…20 The skin and vermilion are separated by a lighter tissue called the white roll that corresponds to the pars marginalis of the orbicularis oris. 9,21 The red line separates the "dry" vermilion from the mucosa, also known as the "wet" lip. The vermilion is composed of keratinized squamous epithelium with a highly vascularized underlying tissue and does not contain sweat glands or hair follicles.…”

“…9,20,21 They are integrated by 3 layers: mucosa, muscle, and skin. 4,9,12,15 The musculature of the lips is a complex structure, and it is made up by the orbicularis oris muscle plus a dozen paired muscles with lift, depression, and sphincter functions. The modiolus is a fibrous structure anchored to the deep layers of the skin in the corner of the mouth, serving as an insert region for some perioral muscles.…”

“…[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.…”

“…[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. 11 In all cases, the layers of the lip must be restored; therefore, when local tissue is available to be a donor area, it becomes the best option to repair the defect.…”