Reconstruction of the lower lip after resection of its venous malformation using a labial mucosal advancement flap – A case report-

Abstract

Large hemangiomas of the lower lip cause cosmetic and functional problems. When surgery is indicated, large lower lip hemangiomas require lip reconstruction after tumor resection. We managed a 33-year-old, male patient with a mass and deformity of the lower lip on the left side, and underwent lower lip reconstruction after tumor resection using a local flap. A two-celled, dark purple, well-defined 42 × 18 mm mass was found extending from near the center of the lower red lip to the commissure on the left side. Using T2-weighted magnetic resonance imaging, the masses showed high density and each small and large bifocal lesion showed a septal-like structure. The lesion’s depth slightly involved the orbicularis oris muscle, and echography revealed that the mass had a relatively well-defined sponge-like area with blood flow signal. The imaging diagnosis revealed a hemangioma of the left lower lip. The tumor was resected with one layer of the orbicularis oris muscle. A wide trapezoidal mucosal flap with a median flap base from the resectional margin to the buccogingival sulcus was set and rotated to the defect area. Histopathological diagnosis revealed venous malformation of the lower lip. One year after the operation, the lip’s morphology and function were almost satisfactory. A labial mucosal advancement flap is useful for reconstructing large and shallow defects of the lower lip, including the oral commissure, considering the lip’s morphology and function.