Lip reconstructions should provide results of a high degree regarding both functionality and aesthetics. We describe a case of lower red lip reconstruction using a mucosal perforator. An 81-year-old man complained of repeated bleeding from a submucosal venous malformation on his lower red lip, and surgery was performed under local anaesthesia. The venous malformation was completely resected. A 4 cm × 2 cm triangle-shaped flap containing a mucosal perforator, identified using colour Doppler ultrasound preoperatively, was designed in the lower red lip adjacent to the defect. The perforator flap was raised in the submucosal layer, and the defect was covered with the flap in an advancement manner. The flap transfer-related defect was closed, and at the 1-year follow-up examination, no recurrence, drooling, or speech impediment was observed. In this case, excellent functional and aesthetic results were achieved following the low-invasive reconstruction using a mucosal perforator flap.

Lower red lip reconstruction using a mucosal perforator flap is low-invasive and adheres to the concept of "like with like." The location of the mucosal perforator can easily be detected using color Doppler ultrasound.

Bacteria reproduce quickly, with a mean cell production time under ideal circumstances of approximately 20 min. Consequently, a single bacterial cell can multiply to more than 10 billion cells per day. The odor of wounds can be attributed to a combination of two factors (necrotic tissue and bacteria). In addition, both aerobic and anaerobic bacteria contribute to unpleasant odors in the wound environment. A variety of volatile metabolites, including cadaverine, sulfur, putrescine,