Early Results of Vermilion Lip Augmentation Using Acellular Allogeneic Dermis: An Adjunct in Facial Rejuvenation

Abstract

An enlarged labium minus can be bothersome for functional, aesthetic, and social reasons. Labia minora hypertrophy can be congenital or acquired by chronic irritation, exogenous androgenic hormones, or stretching with weights. This can cause inflammation, poor hygiene, interference with sexual intercourse, or intermittent urinary self-catheterization in myelodysplastic women. Aesthetically, an asymmetric or enlarged labium minus causes self-consciousness sexually and when the subject wears tight pants. Previously, labia minora reduction was performed by amputation of the protuberant segment and oversewing the edge, or a wedge of protuberant labial tissue was excised and reapproximated. However, the former technique removes the natural contour and color of the edge of the labium minus, and the latter can result in an incomplete or tight reduction. Therefore, rather than an amputation or a wedge resection, we preserved the natural contour and anatomy of the labium minus by simply reducing its central width through bilateral deepithelialization and reapproximation of the central portion with preservation of the neurovascular supply to the edge. Six patients have undergone this reduction method with excellent results without specific complications.

Fenestration Labioreduction of the Labium Minus: A New Surgical Intervention Concept

“…Other labioreduction surgical interventions such as labial partial amputation, deepithelialized reduction labioplasty, inferior wedge resection and superior pedicle flap reconstruction will be appropriate for clinical implementations [2, 3, 6, 8]. Liao et al and Ostrzenski presented detailed evaluation of each surgical technique relating to labioreduction of the labia minora [9, 10, 13].…”

Voldemort Deformity: Nasolabial Transposition Technique for Severe Nasal Inlet Stenosis

“…1–3 Isolated reports in the literature discuss specific approaches to reconstruction of cocaine-induced nasal deformity, including septal perforation, saddle nose deformity, oronasal fistulas, and midface deformity. 1,4,5 …”

“…Initial approaches to cocaine-induced nasal deformity, including nasal stenosis, drew from operative techniques necessary for nasal reconstruction after soft tissue damage from syphilis or leprosy. 4 More recently microvascular techniques have been described for large defects, however, this approach may result in poor functional and cosmetic outcomes. 1 …”

“…4 The tunneled nasolabial flap is employed primarily for nasal deformity due to contracture of nasal lining. Reconstruction starts by lateral vestibular incisions and the release stenotic nasal skin and mucosa.…”

“…Following release of mucosa, a deepitheliazed tissue of a nasolabial flap is tunneled through the lateral vestibular incisions and used to form the nasal lining. 4 In our modified non-tunneled nasolabial flap approach, we excised the stenotic scar tissue and fully detached the ala from the facial skin. The ala was then reapproaximated to the partially deepitheliazed nasolabial flap, resulting in both establishment of internal nasal lining and and increasing the aperature of the external nasal valve.…”