Lower Lip Reconstruction Using Various Flap Surgeries

ABSTRACT

Lower lip defects can result from congenital or acquired problems, such as congenital naevi, hemangioma, tumor, trauma and infectious disease. The principal function of the lip is oral competence. The lips also play a role in deglutition and articulation, as well as being a symbol of beauty and appeal. Defects of up to one third of the lower lip can be closed primarily, but large defects require more complex techniques including distant and free flap reconstruction that have been used with varying degrees of aesthetic and functional success. The authors experienced 10 cases of lower lip reconstruction from July 2002 to March 2003 using V-Y advancement local flap, Abbe flap, double barrel type flap, depressor anguli oris musculocutaneous flap, gracilis musculocutaneous free flap and fibular osteocutaneous free flap combined with forearm fasciocutaneous free flap. The mean age of the patients, 6 males and 4 females, at the time of the procedures was 64.4 years (from 56 to 74 years). Based on our experience, local flap was the best choice for small lower lip defects. However large and total lip defects that do not have normal adjacent tissues required free flap. The disadvantages of the free flap were bulkiness, bad color change, and drooping of the flap. In conclusion, analyzing the results of the various flap surgeries, we could identify the advantages and disadvantages of each type of flaps, which will help us to create the proper method of lower lip reconstruction.