Chin IX: Unusual Soft Tissue Problems of the Lower Face

Abstract

When the editor asked me to write something related to the chin, I (B.M.Z.) told him I would like to concentrate on the soft tissue of the perioral and chin region, something previously not presented before in this Journal specifically or anywhere. Dr. Flores and I have chosen certain soft tissue cases of the lower face, each of which presents certain dilemmas. The reconstructive methods in each case are unique, previously not shown, and represent salvage from prior failures. Case 1 shows how an interior Abbe flap can be used for ipsilateral lip reconstruction. Case 2 shows how a large upper lateral lip elemental loss can be regained from cheek and not the lower lip. Cases 3 and 4 show how to regain proper white roll bulge and symmetry by overcorrection, then exact adjustment in a second stage. Case 5 shows how a failed chin/lip reconstruction can be salvaged to regain sulcus height and aesthetic unit reconstruction. Each case depicts unique reconstructive designs to produce an aesthetic final result.

Reconstructive surgery in advanced perioral non-melanoma skin cancer. Results in elderly patients.

“…A double-barrel wedge resection is a good solution in case of limited primary surgery. 18 For mild deformities dermal fillers or autologous microfat grafting may be an option. 19 More serious deformities need musculo-cutaneous flaps for repair.…”