The Subcutaneous Pedicle Flap in Melolabial Reconstruction

Abstract

In our experience, the subcutaneous pedicle advancement flap is often ideally suited to the reconstruction of cutaneous defects adjacent to the melolabial crease. We have been particularly satisfied with the results of this reconstructive technique when addressing deep defects adjoining the alar facial sulcus in patients with full cheeks.

Postoperative Outcomes of Local Skin Flaps Used in Oncologic Reconstructive Surgery of the Upper Cutaneous Lip: A Systematic Review

“…Six studies reported outcomes on V-Y advancement flaps with the number of patients ranging from 13 to 109 with a range of upper lip defect locations with and without the involvement of neighboring cosmetic unit borders. [9][10][11][12][13][14] There was a single study on ergotrid flaps for upper lateral lip defects, 15 unspecified rotational flaps for apical triangle defects, 16 melolabial rotational flaps for apical triangle defects, 17 Karapandzic flaps for lateral upper lip defects, 18 alar crescent flaps for central upper lip defects, 19 and propeller facial artery perforator flaps for lateral upper lip defects. 20 Overall, there was significant heterogeneity in the complications as well as functional and aesthetic outcomes reported.…”

“…14,16,17,20 Patient satisfaction was greater than 90% in all studies that reported this outcome which included studies using V-Y advancement flaps, ergotrid flaps, and propeller facial artery perforator flaps. [13][14][15]20 V-Y advancement flaps in the study by Carvalho and colleagues 9 reported the highest rate of poor scarring with 4 patients (20.0%) where the upper lip defects had no limitations on location and ranged from full-thickness defects involving the vermillion border to defects involving skin and adipose tissue only. V-Y advancement flaps also reported the highest need for revision surgery by Griffin and colleagues 11 with 14 patients (46.67%) for defects involving skin and adipose tissue only and not extending greater than 5 mm laterally past the melolabial fold, although many did involve the alar and vermillion borders.…”

“…2 Although in our review V-Y advancement flaps showed high rates of facial symmetry, they also reported the highest rate of need for a secondary procedure. Rustad and colleagues 13 noted that one-third of their cases with a defect greater than 4 cm 2 required a secondary debulking procedure to improve the contour of the flap. Of note, the cases in this study all involved the melolabial fold, likely increasing the chance of facial asymmetry due to melolabial fold distortion, particularly with larger flaps.…”

Desenvolvimento De Guia De Perfuração Femorotibial (Ft)

“…A divulsão da mucosa gengival inserida na região anterior da maxila até as tuberosidades maxilares permitiu uma reconstrução da área, respeitando a cor, espessura e textura do lábio. Os retalhos locais, além de ter essa semelhança corroboram com a continência oral e o bom resultado estético, sendo desnecessário o uso de retalhos livres que muitas vezes apresentam um limite na função esfincteriana e normalmente, estão associados a reconstrução do lábio inferior (BERENHOLZ;KESSLER;SEGAL, 1999;RUSTAD et al 1988;LOPICCOLO;KOUBA, 2011;GALIMBERT, et al 2013;CERCI, 2017;HUANG et al, 2017;SPAGGIARI et al, 2019).…”

Hematoma Extradural Em Paciente Vítima De Trauma De Baixa Energia: Relato De Caso

“…A divulsão da mucosa gengival inserida na região anterior da maxila até as tuberosidades maxilares permitiu uma reconstrução da área, respeitando a cor, espessura e textura do lábio. Os retalhos locais, além de ter essa semelhança corroboram com a continência oral e o bom resultado estético, sendo desnecessário o uso de retalhos livres que muitas vezes apresentam um limite na função esfincteriana e normalmente, estão associados a reconstrução do lábio inferior (BERENHOLZ;KESSLER;SEGAL, 1999;RUSTAD et al 1988;LOPICCOLO;KOUBA, 2011;GALIMBERT, et al 2013;CERCI, 2017;HUANG et al, 2017;SPAGGIARI et al, 2019).…”