Bilateral Commissuroplasty and Primary Repair for Lower Lip Defect (30-80%) After Cancer Excision

Abstract

Introduction: Lip reconstruction is an essential step in lip tumors. In this regard, there are many procedures with good outcomes. Flap problems are the possibility of necrosis and an extensive suture line that wrecks aesthetics. Our technique has no flaps for defects more than 30% of the lip, and the suture line is minimal. Methods: This study is a surgical technique report from a single center. The original technique was based on our experience with about 100 patients in 25 years. But in this study, 10 patients were included. After excising the tumor, a bilateral 10-15 mm horizontal skin incision beginning from the commissures to lateral sides was made. The skin and mucosa were dissected from the underlying orbicularis muscle, and the muscle was partially cut about 15 mm from each side. Then the remaining sides of the lip were advanced and repaid in three layers. Finally, the released mucosa was sutured to the angle of incised skin. Results: The patients were followed for at least three years. Oral competence was good, mobility and sensation were well preserved, the scars were less than other flaps, and the aesthetic was satisfying. The patients did not have drooling, flap edema, and pin cushioning. Conclusion: Among various techniques for lower lip reconstruction, the presented technique in this study seems to be safe and straightforward, but to measure all aspects of it, other surgeons need to use this method and express their opinions.