Abstract
Large total or subtotal defects of the lower lip pose a significant challenge for the reconstructive surgeon. The functional reconstructing of the oral sphincter is critical for oral competence and prevention of drooling, improving speech, and eating as well as for esthetic aspects. The authors present a case of a large partial thickness defect of the lower lip and chin following an excision of a neglected basal cell carcinoma. The defect was reconstructed with an anterolateral thigh free flap. Subsequently, due to oral incompetence and lip ectropion, a tensioned interposition unfurled sheet of fascia lata free graft and a composite V-Y advancement flap were utilized to reconstruct the continuity of the oral ring and correct the lower lip ectropion. The procedure resulted in a satisfactory dynamic functional oral sphincter together with a pleasing esthetic result.
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