Closure of Large Surgical Defects on the Cutaneous Upper Lip Using an Island Pedicle Flap

Abstract

The authors have indicated no significant interest with commercial supporters.

Reconstruction of perioral defects post-Mohs micrographic surgery: a dermatological surgeon's approach

“…Primary closure is generally limited to defects smaller than 1 cm in diameter to avoid distortion of the free margin of the lip . Options for closure of larger defects in this area include the melolabial transposition flap, the cheek advancement flap, the tunnelled subcutaneous pedicle transposition flap and the island pedicle flap . The disadvantages of the first three flaps include distortion or ablation of the melolabial fold and, in men, moving glabrous skin in the moustache area.…”

“…25 Options for closure of larger defects in this area include the melolabial transposition flap, the cheek advancement flap, the tunnelled subcutaneous pedicle transposition flap and the island pedicle flap. 25,26 The disadvantages of the first three flaps include distortion or ablation of the melolabial fold and, in men, moving glabrous skin in the moustache area. Blunting of the melolabial fold may be minimized by placement of sutures to the deep buccal tissue to create a new fold.…”

Repair of a Large Defect of the Upper Lip

“…Vertical side‐to‐side closure or wedge resection was not chosen owing to the length of the defect, although a minimum V‐shaped resection, which was necessary given local involvement, aided final closure. Melolabial subcutaneous tissue island pedicle advancement flaps have an excellent blood supply, maintain the anatomy of the melolabial fold, and do not disrupt follicular integrity, allowing men to retain growth of moustache hair …”

“…The island pedicle flap is an excellent option for closure of large and deep defects on the upper cutaneous lip. [1][2][3][4] The reconstruction places incisions at the junction of cosmetic units and uses an island pedicle flap to replace resected tissue with similar tissue, restoring the melolabial fold without distorting surrounding functional and aesthetic structures. This technique is cosmetically and functionally successful, and the symmetry of the oral commissure is maintained.…”

The Transposition Advancement Flap for Repair of Postsurgical Defects on the Upper Lip

“…There have been several publications about pedicle island flaps either perpendicular or parallel to the lip [6,7]. This is a valuable option but presents a considerable risk of trapdoor deformity.…”