A case of upper lip and moustache reconstruction using a submental artery perforator (SMAP) flap

Abstract

The conventional submental island flap is raised based on the digastric muscle belly. Elevation of the flap using a perforator pedicle without the use of muscle has been reported, and the submental perforator was demonstrated as being reliable. In this paper, simultaneous reconstruction of the upper lip and moustache is described; this illustrates the usefulness of this flap. A 63-year-old male sustained a facial burn in a steam bath. A third degree burn occurred on his upper lip; the central area necrosed completely. Upper lip reconstruction was planned using a submental perforator-based flap. The flap was elevated without using the digastric muscle. The perforator consisted of a large artery and a small vein. After the elevation of the flap, a subcutaneous tunnel was made on the cheek and the flap was passed through the tunnel. The lip defect was reconstructed, and the donor site was closed primarily without tension. The flap survived completely.