Reconstruction of the lower lip with a fan-shaped flap based on the facial artery

Nakajima, Tatsuo; Yoshimura, Y.; Kami, Toshiaki

doi:10.1016/0007-1226(84)90042-0

Cited by 58 publications

(23 citation statements)

References 2 publications

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“…2 Although small to moderate defects can be reconstructed successfully with the use of local flaps, [3][4][5] manipulation of local tissues to close larger defects can be problematic. Techniques described by Gillies and Millard (1957), 6 Karapandzic (1974), 5 Webster et al (1960), 7 McGregor (1983), 3 and Nakajima et al (1984), 8 provided possible solutions to such problems. Despite this, commissure distortion and miscrostomia 9 continue to remain obstacles in the reconstruction of total lower lip defects.…”

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confidence: 99%

Free Radial Forearm Flap Lip Reconstruction

Daya

Nair

2009

Annals of Plastic Surgery

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Lip reconstruction is best suited to the dictum of replacement of like tissue with like. The use of the remaining lip in the use of the lip reconstruction becomes more difficult as the size of the defect increases. The use of local tissue for subtotal lower lip loss problems like microstomia and facial and commissure distortion are real risks. The use of free tissue transfer becomes especially an attractive option when in addition to the lip there is associated loss of other aesthetic units and/or mandibular bone loss. The potential value of local perioral tissue is more likely to maintain dynamic and sensory function of the lip.Five patients were included in the clinical series during a period of 3 1/2 years since January 2002. All 5 patients were men. The age ranged from 15 to 67 years. Four patients underwent reconstruction by composite radial forearm flaps including both the cutaneous nerve of the forearm and the palmaris longus tendon. A single patient in this group had a partial brachioradialis muscle flap raised as chimeric component to the composite radial forearm flap. In the fifth patient, 2 simultaneous free radial forearm flaps were used for both upper and lower lip and bilateral buccal mucosal reconstruction. All patients achieved the goals of providing an adequate mouth opening with competence. The refinement of dynamic palmaris sling attachment to the perioral muscle provided for very good oral competence and support. In the single patient, adding bulk with the brachioradialis muscle to the neo lower lip most likely served to improve both aesthetics and lip function. With the use of free flaps an adequate labial sulcus, near dynamic sphincter control and sensation can be restored. The major drawback, however, is aesthetics of the lip. Further refinements like vermillion tattooing, fat injections or defatting by liposuction, and secondary mucosal flap surgery to provide the neolip with a vermillion are beneficial.

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confidence: 99%

Free Radial Forearm Flap Lip Reconstruction

Daya

Nair

2009

Annals of Plastic Surgery

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“…8,9 Though other innervated composite tissue transfers have been described by Nakajima T, Yoshimura T, Kami T et al, the fan flaps still enjoy more popularity worldwide owing to their reliability and simplicity. 9,10 This modified fan flap should be avoided in patients with extensive submucous fibrosis as the buccal mucosa would not be pliable and would lead to distortion of neovermilion. Also, this flap cannot be used in cases where marginal mandibulectomy has to be done leading to loss of buccal sulcus.…”

Section: Discussionmentioning

confidence: 99%

Modified Mc-Gregor’s fan flap for lower lip reconstruction: a two years institutional experience

Shah

Patel

2018

Int Surg J

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Background: Aim of the study was to evaluate the modified fan flaps done during the past two years with regard to applicability, reliability, functional perspective and complications.Methods: All the cases of lower lip defects which were reconstructed using modified Mc Gregor’s fan flaps were included and followed up prospectively at periodic intervals up to 2 years. The indications, applicability to defect size, postoperative aesthetic and functional results and drawbacks were noted.Results: Total 21 modified fan flaps were done during this period. All were done for squamous cell carcinoma affecting lower lip. All the flaps survived, four patients had marginal mucosal loss of neovermilion which healed by secondary intention, 1 case of Bilateral modified Gilles fan flap developed little microstomia, 1 flap with bilateral fan flap had dehiscence of suture line leading to significant morbidity which later had to be closed by secondary resuturing.Conclusions: The modified Mc-Gregors fan flaps are safe and reliable flap for lower lip reconstruction in terms of acceptability and function.

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“…When planning reconstruction of lower lip, several major points should be taken into consideration, as suggested by Fujimori [13] and Nakajima et al [14]:…”

Section: Discussionmentioning

confidence: 99%