Reconstruction of the lower lip with two flaps from the upper lip hinged on the superior labial vessels

Abstract

In 1848, Stein described a method of reconstructing the lower lip with 2 flaps from the centre of the upper lip hinged on the labial vessels (Fig. 1). This method however badly deforms the philtrum. Estlander (1877) described a lateral flap from the upper lip but this tends to divide the commissure and lead to dribbling of saliva. Kazanjian and Roopenien (1954) described a modification of Stein's operation in which the 2 flaps were taken from each side of the philtrum (Fig. 2); it is useful in smaller defects of the lower lip. For larger defects, i.e. up to 80 per cent of the lower lip, the modification of Wexler and Dingman (1975) gives satisfactory results (Fig. 3). Both commissures and the philtrum are preserved. I have used this technique in a number of cases of present 2 to illustrate the method and the results.