Total lower lip reconstruction: a review of recent advances

Shukla, Aishwarya; Loy, Kelsey; Lu, G. Nina

doi:10.1097/moo.0000000000000926

Cited by 6 publications

(7 citation statements)

References 50 publications

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“…Our study has notable limitations, including the exclusion of free flaps, which, although complex and carry a high risk in elderly patients with comorbidities, can be an excellent reconstructive option when performed by an experienced microsurgeon. These procedures are particularly effective for patients with defects exceeding 80% of the lower lip with involvement of the chin region [4,[35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

Russo,

Pentangelo,

Ceccaroni

et al. 2024

JCM

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Background: Lower lip reconstruction is crucial to restore oral integrity post-cancer excision. A perfect balance between form and function should be achieved. With an aging demographic, adapting surgical methods to meet the unique needs of the elderly becomes imperative. Our study aims to introduce a specialized algorithm for lower lip reconstruction; it was tailored to geriatric patients and emphasized the use of “simpler flaps”. Additionally, “Pearls and Pitfalls” were provided for surgeons approaching lower lip reconstruction. Methods: Between January 2018 and June 2021, a retrospective study was carried out. Data collection included patient demographics, defect attributes, reconstructive approaches, flap viability assessment, wound healing, and complications. The follow-up was carried out for a period of a minimum of 6 months. Results: Among 78 patients, squamous cell carcinoma predominated with a mean defect area of 3308 cm2. Postoperative complications were recorded in two patients. All patients reported sensory restoration and overall satisfaction at the 6-month follow-up; secondary procedures were not necessary. Conclusion: Our reconstructive algorithm, focused on elderly patients, prioritizes less invasive reconstructive techniques and introduces innovative modifications to the established methods to achieve both aesthetic and functional outcomes with a low complication rate. In patients undergoing lower lip reconstruction, the subjective microstomia was found to be less relevant than the objective microstomia.

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Section: Discussionmentioning

confidence: 99%

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

Russo,

Pentangelo,

Ceccaroni

et al. 2024

JCM

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“…The edges of the lips are outlined by the white roll, and damage in this area often leads to noticeable scarring, highlighting its significance as an anatomical landmark. The muscles of the mouth, primarily the orbicularis oris, encircle the mouth and converge at the lip ends to form the modiolus, which enables the function of the oral sphincter [ 1 - 4 ].…”

Section: Anatomy Of the Mouthmentioning

confidence: 99%

“…The mouth, a distinct structure in the lower third of the face, is a unique mobile organ that serves both cosmetic and functional purposes [ 1 - 4 ]. Although it typically maintains a specific anatomical position and size, preferences for the size of the mouth vary according to individual, racial, and societal factors, resulting in an ambiguous definition of microstomia [ 3 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, we intend to examine different reconstructive techniques for treating microstomia, with a focus on the oral commissure. This complex area is where the mucosa and orbicularis oris muscles of the upper and lower lips converge [ 1 - 4 ]. Reconstruction in this region presents challenges from both functional and aesthetic perspectives [ 15 - 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevention and treatment of microstomia

Ki,

Park

2024

Arch Craniofac Surg

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The mouth, located in the lower third of the face, is a uniquely visible structure. It serves as a vital organ both aesthetically and functionally, playing a key role in speech, expression, and fundamental oral functions. Consequently, any alterations or defects in its shape, due to various causes, can lead to aesthetic and functional deficiencies. These issues may also result in challenges with social interactions and a decrease in confidence. In cases of microstomia, various surgical approaches are proposed based on the location, extent, shape, and cause of the defect, leading to numerous case reports. Plastic surgeons are proficient in oral reconstruction; however, cases of microstomia are relatively rare, which reduces their familiarity and interest in these cases. Additionally, preferences for oral size and shape vary according to factors such as geographical region and ethnicity, further complicating the functional definition of microstomia. Therefore, both subjective patient and physician judgments play crucial roles in the diagnosis and treatment of microstomia, as these may vary depending on individual and societal aspects. This review aims to classify the various causes and definitions of microstomia, as well as its non-surgical and surgical treatment options, with the goal of the treatment of this condition.

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“…Lower lip vermilion is a common site for squamous cell carcinoma (SCC), 1,2 and after vermilionectomy, reconstructing resulting surgical defects requires careful consideration of defect shape, size, and depth to achieve functional and aesthetically favorable outcomes. 3 Lip length maintenance, orbicularis oris function preservation, and the minimization of visible scarring and anatomic distortion are essential to ensure ideal reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Myomucosal composite graft: A simple technique for full‐thickness vermilion defects of the lower lip

Lee,

Han,

Jeong

et al. 2024

Head & Neck

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Reconstruction of vermillion defects of the lower lip requires careful consideration of functional and aesthetic aspects. Traditionally, various local flap methods involving tissue advancement from the corner of the mouth, lateral chin, and medial cheek have been commonly employed to fill lower lip defects. However, these approaches have inherent limitations, which include technical complexity, disruption of the orbicularis oris muscle, lip tightening, microstomia, and visible scarring. To overcome these limitations, we employed a free myomucosal composite graft from the lower lip to reconstruct small to medium vermilion defects. Our technique is based on a simple and reproducible surgical approach that facilitates natural volume rearrangement of tissues. Moreover, this method enables precise inset and tension‐free repair, prevents lip tightening, and offers excellent aesthetic outcomes with no vertical scarring and appropriate color matching with surrounding tissues.

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Total lower lip reconstruction: a review of recent advances

Cited by 6 publications

References 50 publications

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

Lower Lip Reconstruction after Skin Cancer Excision: A Tailored Algorithm for Elderly Patients

Prevention and treatment of microstomia

Myomucosal composite graft: A simple technique for full‐thickness vermilion defects of the lower lip

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