Functional lower lip reconstruction with the modified Bernard–Webster flap

Denadai, Rafael; Raposo-Amaral, Cássio Eduardo; Buzzo, Celso Luiz; Raposo‐Amaral, Cesar Augusto

doi:10.1016/j.bjps.2015.07.019

Cited by 15 publications

(13 citation statements)

References 28 publications

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“…Similar results concerning neurosensory preservation were shown and discussed in the literature by other authors adopting similar techniques (modified Bernard-Webster technique) [ 20 ]. Their results are quite unsatisfactory for aesthetic and function because of lack in vermillion reconstruction and microstomia resulting from the use of tissue from the unaffected upper lip, unlike the cases reconstructed with our technique.…”

Section: Discussionsupporting

confidence: 83%

“…Aesthetic and functional results were considered for symmetry, shape, similarity in tissue texture, annexes, mouth opening, ability to chew and wear a prosthesis when necessary, and even for some neurosensory preservation or recovery, as shown in Table 1. Other authors using similar techniques (without similar aesthetic and functional results) reported neurosensory preservation or recovery after reconstruction, confirming the technique's rationale [20].…”

Section: Discussionsupporting

confidence: 62%

“…The functional and aesthetic evaluation of the reconstructed cases was satisfactory because of symmetry at rest and at motion when smiling, speaking, and chewing, for shape, annexes, tissue texture, and even for some sensitive and motor nerve recovery. Symmetry was also preserved at the unaffected lip areas of opposite and contralateral lip differently from other most common reconstruction techniques rotating flap from unaffected lip areas, with consequent tractions and asymmetry for the nose and other lip areas [ 15 , 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 98%

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Lip Reconstruction by Double Layer and Double Flap New Combination Technique: A Case Series

et al. 2022

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In the past, lip reconstruction after ablative surgery has been performed by primary closure and more recently by free flap transfer technique. Cheek’s skin flap has been used to reconstruct the lower lip cutaneous portion. This study presents a reconstructive method for the vermillion and the lip’s cutaneous portion using the Goldstein–Robotti techniques (for the vermillion) and the buccinator flap to reconstruct the cutaneous lip portion and the perioral muscles. This procedure allows a complete reconstruction with a double layer technique for defects of more than one-third of both lips, together or alone, including modiolus, showing satisfactory functionality and aesthetics. The procedure was carried out by splitting the buccinator muscle and elongating the upper and lower buccinator bundles, together or alone. Soft tissue blunt dissection prevented most facial nerves and vessels injuries, ensuring blood supply and an amount of lip sensitivity. Even in the case of facial vessel ligatures after neck dissection, the technique was possible basing the flap pedicle on the internal maxillary artery branches (buccinator) and contralateral facial vessels (orbicularis). We present a case series of six reconstructions of various defects of the upper and lower lips, including the commissure after ablative surgery for squamous cell carcinoma and polymorphous adenocarcinoma. The results showed satisfactory functional and aesthetic outcomes, with similar tissue texture, static and dynamic symmetry achieved for all the patients.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 98%

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Lip Reconstruction by Double Layer and Double Flap New Combination Technique: A Case Series

et al. 2022

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“…4 Ideally local flaps should be chosen as they can offer dynamic functional reconstruction and good color match, the Karapandzic and the Webster-Bernard flaps have been the most adopted reconstructive local options for large lower lip defects up to 80%. [9][10][11] However local flaps are not always possible, and have major drawbacks such as microstomia, abolition of givobuccal sulcus, drooling, and additional facial scars. 2,[8][9][10] When local flaps are not viable option, free flap reconstruction are considered; static options described include FRFF with a palmaris longus sling, free ALT flap, whereas dynamic options include functional free gracilis muscle flap, free serratus anterior muscle flap have been described in literature.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11] However local flaps are not always possible, and have major drawbacks such as microstomia, abolition of givobuccal sulcus, drooling, and additional facial scars. 2,[8][9][10] When local flaps are not viable option, free flap reconstruction are considered; static options described include FRFF with a palmaris longus sling, free ALT flap, whereas dynamic options include functional free gracilis muscle flap, free serratus anterior muscle flap have been described in literature. The free radial forearm is currently the "gold" standard for total lower lip defects due to its thin, pliable skin, long pedicle, ease of harvest, and includes vascularized palmaris longus sling as well as reasonable color match.…”

Section: Discussionmentioning

confidence: 99%

The Use of Vastus Lateralis Muscle Flap for Functional Lip Reconstruction

Lelala

Pienaar

Hudson

2021

Journal of Craniofacial Surgery

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Background: Total or near-total lip defects poses a serious challenge to a reconstructive surgeon with static procedures not providing desired functional and aesthetic outcomes. The dynamic lip reconstructive methods using functional muscles have become a current issue in recent years showing admirable results. This study present 3 cases of successful total and near-total lip reconstruction are presented using vastus lateralis muscle. Methods: This is a retrospective analysis of a consecutive series of 3 patients (2 men and 1 woman) aged 44 to 56 years (mean) who had resection of extensive squamous cell carcinoma 2 had both upper and lower lip involved and 1 had lower lip involvement only. After resection patients had near total full thickness lower lip defect and 40% upper lip defect. The innervated vastus lateralis muscle free flap was transferred to the lip and end-to-end vascular anastomosis on the facial artery and end-to-side to internal jaguar vein was performed. The marginal mandibular branch of the facial nerve was used for nerve coaptation. The inner and outer surfaces of the flaps were grafted with a thick-split-thickness skin graft. Drooling rating scale and patient and observer scar assessment scale as well as electromyography were performed to evaluate oral competency and aesthetic outcome. Results: All patients underwent single stage near-total lower lip and 2 had part of upper lip reconstruction successfully and survived the surgical operation. One patient lost the skin graft and was managed consecutively and muscle granulated and healed. Two patients underwent radiation therapy and 1 died before starting radiation due to other unnatural causes. The 2 patients achieved perfect oral sphincter competence without drooling and at 9months postoperative demonstrated successful reinnervation of the vastus lateralis muscle. Conclusions: This study demonstrates that lip reconstruction using an innervated vastus lateralis muscle free flap is a reliable method, providing a functional lip

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