Lower Lip Reconstruction Using Unilateral Nasolabial Gate Flap (Fujimori Technique)

Abstract

Abstract Background: In the medical literature there are multiple reconstructive procedures for small and medium size defects of the lower lip, but only a few methods for larger defects involving the whole lower lip. Choosing the repairing procedure for larger lower lip defects must take into account two aspects: flap or flaps used should be local flaps, and suture lines should correspond to the natural facial creases or follow the functional lines of different facial aesthetic units. Finally, the flap or flaps should be large enough to restore the entire postexcisional defect. However, the more tissue is lost from the lower lip, the more challenging the reconstruction is from a functional and cosmetic point of view. Material and methods: During the last 2 years in the Oral and Maxillofacial Surgery Department of the County Emergency Clinical Hospital in Tîrgu Mureș, the unilateral Fujimori technique has been successfully used for the reconstruction of large lower lip defects in 4 patients with extended, neglected squamous cell carcinomas involving almost the whole lower lip tissue. These patients underwent complex surgical and oncological treatment. Surgery was performed in two stages: first, excision of the tumor and immediate lip reconstruction, and then removal of submandibular lymph nodes (level I), in the second stage. Results: The aesthetic and functional recovery of these patients was very good, with no need of other subsequent surgical corrections. Conclusions: The postoperative reconstruction of large defects of the lower lip is far from optimal, but it is very important to restore an adequate muscle function, the lip continence and a satisfactory facial appearance.