Lip Reconstruction With Local M-Shaped Composite Flap

Abstract

The primary management of lip malignancies is radiotherapy or complete surgical resection. Surgical resection brings a full-thickness defect of lip tissues, and management of the resulting lip defect needs a surgical technique that maximizes functional and cosmetic outcomes. The use of local tissue flaps forms the basic concept of lip reconstruction. There are many techniques reported using the remaining lip and local adjacent tissues. Almost all of these techniques emphasize the innervated sphincter function after lip reconstruction. Authors present their experience in lip reconstruction by an M-shaped local composite flap. An M-shaped flap presents an incision line lying on the labiomental sulcus of the lower lip; on this line, 2 half-thickness Burrow triangles are created. The Burrow triangle allows tissue transposition to close the postsurgical defect. A similar surgical technique is presented also for the upper lip. Functional sphincteric recovery is assured by the integrity of the orbicularis oris muscle because of minimal alteration in the orientation of the muscle and the reconstruction muscular anatomic plane; moreover, such flap preserves the integrity of the corner of the mouth, preserves the sensibility of the lip, and has minimal aesthetic impact due to the camouflage of scar on the labiomental sulcus.