Upper Lip Reconstructions in Acquired Defects Excluding Melanocytic Nevi and Vascular Tumors

Abstract

As one of the face's prominent features, the lips help to eat, drink, suck, speak, and kiss, and their functions show certain emotional expressions while communicating with people. Although the lips are without bone and very flexible, they have very close relationships with the upper jaw. Furthermore, the two lips together make the oral sphincter, and none of them has superiority over the other on behalf of the sphincteric functions. A total of 36 cases of upper lip reconstruction were reviewed retrospectively. Melanocytic nevi and tumors in the vascular origin were excluded from the study. All cases were performed sequentially over 25 years by the author. Indications, techniques, postoperative care, complications, and patient characteristics were taken into consideration for each case. Most of the defects resulted from malignant tumor excisions. The procedures used for the upper lip reconstruction included direct closure (n: 5), cheek bilobed flap (n: 4), perialar crescentic advancement flaps (n: 8), full-thickness skin grafting (n: 1), Estlander flap (n: 1), V-Y advancement flaps (n: 3), superiorly based nasolabial peninsular flap (n: 3), perforator-based island flap (n: 6), bilateral depressor anguli oris flaps (n: 1), and musculocutaneous flap combined with local skin flaps (n: 3). No hematomas, infections, or flap necrosis were reported. One patient died of myocardial infarction during early postoperative days. Most of the defects located on the upper lip can be treated with certain type of perforator-based flaps or perialar crescentic advancement flaps. Since most of the tumors are small or medium sized, an adequate knowledge about these two flaps must be acquired.