Aesthetic reconstruction for large upper lip defects in men

Reverse Facial-submental Artery Island Flap with Reinnervation of the Anterior Belly of the Digastric Muscle

Reconstruction of the upper lateral lip subunit is challenging, and use of several classical local flaps have been previously reported. However, these methods have drawbacks such as visible scarring, anatomic distortion, and functional disability. To obtain satisfactory results, preservation of perioral function is important. We report a case of functional upper lip reconstruction after tumor resection using a reverse facial-submental artery island flap with a reinnervated anterior belly of the digastric muscle (ABDM) without sacrificing the perioral structure. A 73-year-old man presented with basal cell carcinoma on the left upper lip which was widely excised, including the orbicularis oris muscle. The remaining 4 cm × 3.5 cm defect was reconstructed using a reverse facial-submental artery island flap with ipsilateral ABDM. The motor nerve of the ABDM was sutured with the stump of the buccal branch of the ipsilateral facial nerve. The postoperative course was uneventful, and good functional and esthetic recovery were observed at 12-month follow-up. This procedure may be an alternative option for reconstruction of lateral upper lip defects.

New technique of one-stage reconstruction of a large full-thickness defect in the upper lip: bilateral reverse composite nasolabial flap

Lips are important features because of their location, function, and aesthetics. Reconstruction of the upper lip presents the surgeon with one of the greatest challenges. Total upper lip reconstruction is a frequent and demanding procedure, and its difficulty is related to the size and the site of the loss of the aesthetic subunits such as the Cupid's bow and the philtral columns.