Lip reconstruction using the Gillies fan flap

Abstract

The Gillies Fan flap is a single-stage composite rotational-advancement flap for reconstruction of medium to large full thickness lower lip defects. It can be thought of as an extension of the Estlander flap. It is nourished by a narrow superiorly-based pedicle of the superior labial artery. Mobilized tissue includes adjacent lower lip tissue as well as tissue from the opposing lateral lip. The oral commissure is distorted with use of this technique, and sometimes requires a second stage for refinement using a commissureplasty, discussed elsewhere in this issue. This flap is unique when compared with other reconstructive modalities of the lip because it requires a full thickness incision through the lip, thereby resulting in division of neurovascular and muscular structures, and as such has largely been replaced by the Karapandzic flap, which maintains the radial neurovascular supply, better preserving functions of the lip. This is accomplished by making incisions through mucosa and skin only, rather than full thickness as described herein. The Gillies fan flap can also be utilized using the MacGregor modification depending on the scenario.