Total lower lip reconstruction in advanced squamous carcinoma: application of the gate-flap technique.

During the years 1986 to 1988, seven patients with advanced squamous cancer of the lower lip were operated on in our department and the defects were reconstructed by the gate-flap technique. We found that this method affords satisfactory total reconstruction of the lower lip. Better results may be obtained if more attention is given to details such as the thickness of the pedicles, the opening of Stensen's duct, and advancement of the mucosa to form the vermilion. Late distortion due to scar contracture can be corrected by defatting and W plasty.

Unilateral gate flap for reconstruction of the lower lip.

A unilateral gate-flap technique consisting of a nasolabial island flap is presented for the reconstruction of defects in the lower lip after excision of large, laterally located epidermoid tumors. The amount of healthy tissue resected is optimal. The reconstructed lower lip retains sensation and muscle function and is continent with a satisfying appearance. Temporary flap edema and a vermilion notch at the apex of the flap are both avoidable problems. This method may be used in selected patients with large advanced epidermoid cancers of the lower lip.