Lip Repair after Mohs Surgery for Squamous Cell Carcinoma by Bilateral Tissue Expanding Vermillion Myocutaneous Flap (Goldstein Technique Modified by Sawada)

Abstract

Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap. The original technique was modified by Sawada based on bilateral adjacent vermilion advancement flap for closure of central vermilion defects. We report the use of bilateral flaps - Sawada’s technique (instead of unilateral as suggested by Goldstein) in medium (2 cm of extension) to large defects (> 2 cm) to achieve an effective and functional reconstruction of vermillion defects after Mohs surgery for lip cancer.

Mucomuscular Elastic Flap for Lower Lip Vermilion Reconstruction: Experience in a Series of Cases in Pediatric Patients

“…Our series includes exclusively pediatric patients, with different etiology to adults where the most frequently reported vermilion reconstruction is due to carcinoma 1,4,7,8 . In contrast, Goldstein presents a case report of a 15-year-old girl with IH and in this series, benign tumors and traumatic lesions represent the most frequent etiologies of lower lip vermilion defect.…”

“…He proposed an ipsilateral vermilion flap adjacent to the defect, based on the elastic properties of this arterialized myocutaneous tissue. This technique was subsequently modified by Sawada [1][2][3][4] consists of a bilateral advancement flap of the vermilion for the surgical closure of the central defect in the upper and lower lip. 1 The inherent elasticity of the lip tissue offers a unique advantage that allows the released flap to be mobilized up to twice its original length.…”

“…This technique was subsequently modified by Sawada [1][2][3][4] consists of a bilateral advancement flap of the vermilion for the surgical closure of the central defect in the upper and lower lip. 1 The inherent elasticity of the lip tissue offers a unique advantage that allows the released flap to be mobilized up to twice its original length. 3 The objective of this work is to evaluate our experience with unilateral or bilateral mucomuscular elastic flaps for the reconstruction of lower lip vermilion in children.…”

Desenvolvimento De Guia De Perfuração Femorotibial (Ft)

“…A reconstrução labial consiste em um desafio que necessita de experiência e familiaridade com a anatomia local por parte do cirurgião (COPPIT; LIN;BURKEY, 2004;GOLDMAN, et al, 2018;BAUMANN;ROBB, 2008). Anatomicamente, os lábios integram a camada da pele, músculo, mucosa e desempenham papel importante no sistema estomatognático, envolvidos nas funções de fonação, mastigação, deglutição além da sua participação na estética facial (GRAY, 1988;LEE;MOUNTAIN, 2000;MCCARN;PARK, 2005;SIQUEIRA, et al 2012).…”

Uso Da Angiotomografia Na Avaliação De Anomalias Da Aorta Torácica – Ensaio Iconográfico

“…A reconstrução labial consiste em um desafio que necessita de experiência e familiaridade com a anatomia local por parte do cirurgião (COPPIT; LIN;BURKEY, 2004;GOLDMAN, et al, 2018;BAUMANN;ROBB, 2008). Anatomicamente, os lábios integram a camada da pele, músculo, mucosa e desempenham papel importante no sistema estomatognático, envolvidos nas funções de fonação, mastigação, deglutição além da sua participação na estética facial (GRAY, 1988;LEE;MOUNTAIN, 2000;MCCARN;PARK, 2005;SIQUEIRA, et al 2012).…”