Reconstruction of lips – Experience review
Douglas Cheng-Hsing Lo
Department of Oral and Maxillofacial Surgery,
St. Martin De Porres Hospital, Chia Yi City,
TAIWAN
Lips belong to the anterior part of the mouth. They provide many functions, such as aesthetics, eating, communication and much more. From the perspective of anatomy, it is a sphincter structure indeed. Lips are the first point of the human digestive system, responsible for controlling food in the mouth and sealing the anterior part of the oral cavity.
Resection of the lips is easy but reconstruction is very difficult because this is a very dynamic structure. Until now, reconstruction for lip defects is still challenging in head and neck reconstructions. The unique structure of the lips includes intraoral mucosa, vermillion border, muscle and facial skin. Without proper reconstruction of the defect, not only will the aesthetic outcomes be compromised but also functional outcome too. This includes: facial deformity, microstomia, speech impediments, hampered eating and even saliva drooling.
For small to moderate defects, primary closure or local flap is much better than the other methods, since the lips can be stretched and this provides the greatest compatibility. For large defects such as subtotal, total lip or oral commissure defects where more than half of both upper and lower lip tissue has been lost, either distant rotation flap or free flap could be utilised. Comparing these two methods, microvascular free flap is definitely the best. If the free flap is chosen, through proper flap design which includes harvesting the accompanying tendon and tongue flap, as well as adequate bone support if needed, this combination would be a perfect reconstruction method for this particular region.
In this presentation, we will review our cases and present comprehensive lip reconstructions.
