Total lower lip reconstruction is an extremely challenging problem. It more o en a ects the lower lip 90%, and squamous cell car cinoma scc represents 95% of the cases 1 3. Lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. Upperlip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. Simultaneously, the donor burden is shared, often limiting later donor deformity. Thus, when possible, in cases of lower lip reconstruction, tissues from the remaining lip should be employed or a flap should be taken from the upper lip, according to defect size and location 19. Patients with such defects are frequently left with substantial functional impairment and disability.
Soda pdf is the solution for users looking to merge multiple files into a single pdf document. To our knowledge, zook et al 3 in 1980 were the first to report using the vy island advancement flap for upper lip reconstruction following trauma or oncologic resection. Various plans of lip reconstruction with switched flaps the patient was returned to the operating room where the flaps were separated and wider excision was obtained from the lower lip. Reconstruction of the lip commissure with upper and lower. Pdf merge combine pdf files free tool to merge pdf online. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. Jul 02, 2012 direct primary closure without undermining is a reliable method of reconstructing vermilionectomy defects of the lower lip, according to research published online june 18 in the british journal of. But there are other types of lip procedures as well. Lip reconstruction may be required after trauma or surgical excision. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patients age, sex, occupation, and. Apr 15, 2019 lip reconstruction is driven by restoration or preservation of function and aesthetics. The planning and choice of operative methods depended on the quality of the surrounding tissue and the patients age, sex, occupation, and general health. Lips are also common sites for occurrence of skin cancers. This free online tool allows to combine multiple pdf or image files into a single pdf document.
This can all be done with minimal cosmetic and functional disturbance. The vy subcutaneous tissue pedicle advancement flap has been previously described in upper lip reconstruction. Reconstructed lower lip 3 months postoperative i in modified fig. Aug 01, 2001 reconstruction of the lower lip cook, jonathan lambert 20010801 00. These products work by irritating the skin of the lips with ingredients such as capsaicin. The muscles must be carefully repaired to avoid numbness in the lip. However, because dermal fillers are the least invasive option with very little recovery time needed, they are highly popular. Lip reconstruction can generate a considerable challenge to the plastic surgeon because of their role in aesthetic balance, facial expression. Lip reconstruction long island reconstructive surgery. The new technique is an alternative for reconstruction of extensive upperlip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results. Analysis of the lip defect is crucial, as this will guide the method of reconstruction. The upper lip receives its sensibility from the infraorbital nerve, which is a branch of the maxillary division of the trigeminal nerve.
A second surgery is necessary to reconstruct the commissure angle. If there is a deep wound or hole in the lip, mucosa, or mucus membranes can also be used to fill in the area. This patient underwent upper lip augmentation using a soft silicone lip implant. The tumor was removed in two surgical stages, and the wound that resulted from tumor removal measured 2. In their version, the flap was not formally undermined but was. Call 631 423 to schedule a consultation with long island plastic surgeon dr. Lip augmentation nashville, tn franklin lip augmentation. In the head and neck region, scc of the lip is second only to skin cancer in terms of frequency, with an estimated incidence of 0. Larrabee, jr, md procedure selection for surgical reconstruction of lip defects depends on the location and extent of the defect.
Any reconstruction of the lips must include both functional and cosmetic considerations. Aesthetic upper lip reconstruction with vermilion submucosalpedicle crosslip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized cutaneous amyloidosis occurring on the upper lip of a 48yearold man was surgically treated andaestheticallyreconstructed with vermil. Reconstruction of the lip commissure with upper and lower lip. This will help minimize swelling, which is likely to occur. We present a case of lip reconstruction following a total resection of the upper lip. Reconstructive cosmetic surgery long island reconstructive. The two main techniques for reconstructing these defects employ either reconstruction with local tissue or freetissue transfer. The total lip defects resulted from tumor resection n6, trauma n3, and noma n1. Abbe flap figure 2 has aslo been utilized for the reconstruction of the lateral aspect of the lower lip involving the commissure, however this procedure requires the outline to be placed on the upper lip to the half the size of the defect2.
Our pdf merger allows you to quickly combine multiple pdf files into one single pdf document, in just a few clicks. Squamous cell carcinoma accounts for 95% of lip malignancies with 90% of cases affecting the lower lip. During this period, one patient who underwent reconstruction with a myomucosal flap and. Direct primary closure feasible for lower lip reconstruction. Lip reconstruction long island reconstructive surgery long. Defect of 30% of the upper or lower lip can be closeddefect of 30% of the upper or lower lip can be closed primarily great elasticity of. Lip reconstruction surgery in these cases typically uses skin grafts. Reconstruction of the lower lip reconstruction of the lower lip cook, jonathan lambert 20010801 00. Whether dealing with disfigurements, scarring as a result of trauma or cancer treatment, or performing cosmetic procedures to enhance and recontour the body and face, our plastic surgeons take into consideration both the physical and emotional wellbeing of you, our patient. The reconstruction of the lips following the tumor ablation with abbe flap or its modifications may not be always satisfactory because it leaves parallel scars extending to the free vermilion margin, a trapdoor deformity and leave a cleft lip like appearance. Corrective 3d reconstruction of lips from monocular video.
The modified estlander flap is based more medially to the initially proposed flap and seeks to avoid lip commissure deformations. Feb 08, 2012 functional and cosmetic considerations must be included in any lip or chin reconstruction. Surgical technique the split orbicularis myomucosal flap. Post post operative care for lip augmentationoperative. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. There were concomitant chin and mandible defects in three and four patients.
Reconstruction e i iure i uer a er i uie ee uig ubea a aabia a. Large lower lip defects karapandzic flap may be used in lesions up to 80% of lip, may cause microstomia bernardburows procedure provides new lip tissue, but sensation and competence problems can lead to drooling free flap may be needed in massive defects or those with insufficient lip or cheek tissue for reconstruction. A small 3mm incision was placed in the corners of the mouth so the scar cannot be seen. Lip reconstruction list of high impact articles ppts.
This study presented a simplified, systematic, and literaturebased strategy for planning lower lip reconstructions using efficient and reproducible. Lip tumors that produce lip defects are either congenital such as vascular malformations and hemangiomas or acquired such as basal cell carcinoma, squamous cell carcinoma and leukoplakia. The sensory innervation of the lower lip is provided by the mental nerve. First lip reconstruction was performed in 25 ad by a roman surgeon who made relaxing incisions in the cheek to close defect of the lower lip 1.
Lip trauma also plays a major role in producing defects. Total reconstruction of the upper lip using bilateral. In defects with 3570% lip involvement, the karapandzic, abbe, estlander, mcgregor or. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive option to use is provided. Reconstruction involving the lip and perioral facial structures is particularly delicate given the visibility of this area and its impact upon ones appearance, speaking, communication and social interaction. This is a perfect technique in cases where more than half of the lip is affected by the defect. The aesthetic goals of lip reconstruction are to provide adequate replacement of external skin while maintaining the aesthetic balance of the vermiliocutaneous junction and lip aesthetic units. Lip reconstruction and aesthetics are the main focus of reconstructive, cleft and aesthetic surgeons. Functional and cosmetic considerations must be included in any lip or chin reconstruction.
Lower lip reconstruction strategies patient had a lesion covering 90% of the lower lip that was reconstructed using the websterbernard technique and a tongue flap figure 7, table 1. Postpost operative care for lip augmentationoperative care for lip augmentationoperative care for lip augmentation at home after procedure. To schedule an appointment please submit an online inquiry, call us at 202. Outcomes following vy advancement flap reconstruction of. There are many reasons why this may happen to an individual and whether your needs stem from a congenital or genetic defect. Cheek skin is recruited to add length to the lip repair to lessen the degree of microstomia. However, they ignore the rolling nature of the inner contour and thus sacri. The infraorbita nerve provides sensation to the upper lip, cheek, ala, and nasal sidewall. Lip defects may be caused by disease, trauma or birth defects such as cleft lip. Lips serve a vital role in cosmetic beauty of the face and are an important functional structure for speech, chewing, and swallowing. This is more so when the resection is total and a complete lip has to be constructed. Reconstruction of the lower lip involved the rotation of a lateral area of the upper lip to the commissure. Reconstruction of the lower lip and chin with the composite radial forearmpalmaris longus. Begins on the vermillion border of the lip to one side of the midline as a small area of thickening, induration, and ulceration.
Cancer of the lip is a relatively common malignancy of the head and neck region. Reconstruction of the lower lip, dermatologic surgery 10. Lip reconstruction after tumor ablation world journal of plastic. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and. The most common type of lip surgery is lip augmentation sometimes referred to as lip enhancement surgery. In addition to this, solar radiation injury also affects the lower vermillion. These flaps of skin are added to the injured lip to restore it. How to merge pdfs and combine pdf files adobe acrobat dc. In this chapter, we focus on the surgical reconstruction strategies for acquired deformities commonly seen after cancer resections. Giles fa gillies fan flap for lower lip reconstruction case. Oncologic resection of cancer remains a major cause of large lip defects. Technique for the reconstruction of oral commissure.
Elliot duyboys and the team at associated plastic surgeons understand that there are often many emotions that accompany a disfigurement or loss of physical attributes. Squamous cell carcinoma scc is the most common malignancy affecting the lip, unlike the rest of the facial skin where basal cell cancer is predominant. Combined rotation and advancement flap reconstruction for. This makes the lips swell slightly, temporarily creating the appearance of fuller lips suction pumps, a special device for lips uses vacuum pumping to increase blood pressure in each lip and to pull. Aug 01, 2018 lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. Direct primary closure without undermining is a reliable method of reconstructing vermilionectomy defects of the lower lip, according to research published online june 18 in the british journal of. Tellioglu10, in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free microsurgical flap from the forearm radial flap, for total reconstruction of the lower lip. Easily combine multiple files into one pdf document. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive. Even small abnormalities can be apparent because of the. Aside from dermal fillers, other options include fat transfers and facial surgery lip augmentation. Elevate the head of the bed with at least two pillows for the first night following the procedure. Lip reconstruction connecticut stanislawmdstanislawmd.
Apr 18, 2020 lip reconstruction surgery in these cases typically uses skin grafts. Squamous cell carcinoma most frequently occurs in the mucosa of the lower lip. Lip carcinoma is a common cancer of the head and neck region. Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively. Even small abnormalities can be apparent because of the prominent location on the face. Lip reconstruction is the process of maintaining oral competence, sufficient oral access and preservation of sensation after severe injury, burn or in case of lip cancer.
Unm health systems plastic surgeons emphasize the importance of treating the patient as a whole. The functional goals of lip reconstruction are to maintain intraoral mucosal lining and to preserve the surface area of the oral aperture. Squamous cell carcinoma scc is the most common malignancy affecting the lip, unlike the rest of. The new technique is an alternative for reconstruction of extensive upper lip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results. Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction. Upper lip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. Giles fa gillies fan flap for lower lip reconstruction. Nov 07, 2016 general considerationsgeneral considerations for upper lip reconstruction, lower lip can be used, butfor upper lip reconstruction, lower lip can be used, but vice versa is avoided. For defects involved less than 30% of lips, primary closures are sufficient. Jun 30, 2010 large lower lip defects karapandzic flap may be used in lesions up to 80% of lip, may cause microstomia bernardburows procedure provides new lip tissue, but sensation and competence problems can lead to drooling free flap may be needed in massive defects or those with insufficient lip or cheek tissue for reconstruction. If you are interested in lip reconstruction and would like more information, contact our office in huntington today. This is the lip reconstruction technique used when more than seventyfive percent of the lip is affected by the defect. Aesthetic upper lip reconstruction with vermilion submucosalpedicle cross lip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized cutaneous amyloidosis occurring on the upper lip of a 48yearold man was surgically treated andaestheticallyreconstructed with vermil. Other causes include trauma, burns, infectious diseases, hemangiomas, and congenital clefts.
Lower lip reconstruction is more significant, because oral competence depends greatly on a functional lower lip having good muscular function, adequate height and sensation. The websterbernard flap is used to reconstruct the lower lip by advancing cheek tissue and the remaining lip tissue medially. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer. The repair is completed in two treatments, which are at least two weeks apart. Aesthetically, facial units should be reconstructed with adequate tissue match in terms of colour and texture, aiming at symmetry as well as preservation of the apparent. Gillies fan flap, lip, carcinoma, surgery, treatment introduction lips have important aesthetic and functional roles in the human body. Lip reconstruction plastic and reconstructive surgery. Lip augmentation is performed several ways, depending on your desired outcome.
Lip deformity can adversly affect ones overall facial appearance and can be a great source of concern to the affected person. Rbcp total reconstruction of the lower lip with face flaps. Lip plumper is a cosmetic product used to make lips appear fuller. Aesthetic upper lip reconstruction with vermilion submucosal. Basal cell cancers typically occur on the upper lip whereas squamous cell cancers occur on the lower lip. Combined rotation and advancement flap reconstruction for a defect of the upper lip.
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