eMedicine Specialties > Plastic Surgery > Head/Neck
Lip Reconstruction: Multimedia
Updated: Mar 18, 2008
Multimedia
 | Media file 1: Aesthetic units of the face. |
 | Media file 2: Superficial anatomy of the lower face. |
 | Media file 3: Muscular anatomy of the face. |
 | Media file 4: Cutaneous innervation of the face and facial nerve distribution. |
 | Media file 5: Blood supply and lymphatic drainage of the face. |
 | Media file 6: Wedge excision and primary closure. |
 | Media file 7: Abbe flap technique. |
 | Media file 8: Estlander flap technique. |
 | Media file 9: Gillies fan flap technique. |
 | Media file 10: Karapandzic flap technique. |
 | Media file 11: Bernard-Burow flap technique. |
 | Media file 12: A and B. Central upper lip defect reconstruction with the perialar skin crescent method that retains motor and sensory innervation to the advanced upper lip lateral elements and uses an Abbe flap for philtral reconstruction. Used with permission of WB Saunders Company. |
 | Media file 13: Bilateral depressor anguli oris total lower lip reconstruction. A. Flap design shows the relationships of the incision, muscle, motor nerve (VII), and sensory nerve (V). B. Flap transposition reorients the depressor anguli oris to restore the lower lip oral sphincter. Vermilion is created by mucosal advancement. C. Flap insert and direct donor defect closure complete the reconstruction. |
 | Media file 14: von Bruns nasolabial flap technique. |
 | Media file 15: A and B. Lip reconstruction. Bilateral orbicularis oris composite flap reconstruction of a large central upper defect. The aesthetic qualities of this reconstruction are enhanced by an Abbe flap philtral reconstruction. |
 | Media file 16: A bilateral levator anguli oris flap total upper lip reconstruction. A. Flap design shows the relationship of the incisions, muscle, and lower lip Abbe flap for philtral reconstruction. B. Flap transposition reorients the muscles to become the upper lip sphincter. Motor (buccal) and sensory (infraorbital) nerves entering the lateral flap border are carefully preserved in dissection and transfer. Mucosal advancement restores vermilion and an Abbe flap restores the philtrum. C. Donor defect is closed directly and the Abbe flap pedicle is divided at 2 weeks. |
 | Media file 17: Left: A patient with midline and left lateral lesions each occupying less than one third of the lower lip. Right: Wedge excision of the lesions. |
 | Media file 18: Left: W-closure with bilateral advancement flaps of midline defect along with mucosal advancement flap of left lateral defect. Right: Postoperative follow-up showing excellent aesthetic results. |
 | Media file 19: Left: Excision of large lesion occupying greater than 85% of the upper lip. Center: Selection of regional temporal interpolated flap based on the temporal artery. In this case, significant involvement of the cheek as well as compromised vasculature secondary to Mohs surgery did not allow for an advancement flap such as the Karapandzic flap. Right: Postoperative follow-up showing good aesthetic reconstruction of the ala of the nose, upper and lateral lip, and cheek. |
 | Media file 20: Left: A patient with a midline upper lip lesion. Right: Reconstruction of medium to large upper lip defect with a modified unilateral Karapandzic flap. The nasal defect was closed with an internal mucosal advancement flap, a cartilage graft from concha of the ear, and a paramedian forehead flap for external reconstruction. |
 | Media file 21: Left: Mohs surgical excision of the upper lip lesion affecting the left ala of the nose and leaving a defect occupying approximately 50-60% of the upper lip. Right: Postoperative follow-up showing good aesthetic reconstruction of the left ala of the nose an upper lip. |
 | Media file 22: Left: Superficial lower lip cancer. Center: Resection of cancer with margins including the entire segment of the dry and major segment of the wet portion of the lower lip. Right: Vermilion advancement flap after dissection intraorally to the gingivobuccal sulcus. |
 | Media file 23: Left: Small lower left lip lesion. Center: Excision and primary closure. Right: Postoperative results. |
 | Media file 24: Left: Full-thickness left upper lip defect. Center: Medial advancement of the upper lip along subunits lines leading to the final scar being placed along the philtral column of the upper lip. Right: Postoperative results. |
 | Media file 25: Left: Near midline small upper lip defect. Right: Burow wedge excision with primary closure (A-to-T flap). |
 | Media file 26: Upper left: Left upper lip defect (<1/3). Upper right: Medial advancement of the upper lip along subunits lines, leading to the final scar being placed along the philtral column of the upper lip. Lower left: Early postoperative follow-up. Lower right: Late postoperative follow-up. |
 | Media file 27: Left: Right upper lip defect (~1/3). Right: Primary closure of defect. |
More on Lip Reconstruction |
| Overview: Lip Reconstruction |
| Workup: Lip Reconstruction |
| Treatment: Lip Reconstruction |
| Follow-up: Lip Reconstruction |
 Multimedia: Lip Reconstruction |
| References |
| « Previous Page |
References
Dieffenbach JF. Die operative chirurgie. Vol 1. Leipzig Brockhaus: 1845:423.
Dieffenbach JF. Chirurgische Erfahrungen, bensonders uber die Wiederherstellung Zerstoerter Theile des Menschlichen Koerpers nach Neuen Methoden. Berlin: TCF Enslin; 1829:34.
Sabattini P. Cenno storico dell-origine e progresso della rinoplastica e cheiloplastica seguito dalla descrizione di queste operazioni sopra un solo individuo. Bologna: Balla Arti; 1838.
Abbe R. A new plastic operation for the relief of deformity due to double harelip. Med Rec. 1898;53:447.
Estlander JA. Methode d'autoplastie de la joue ou d'une levre par un lambeau emprunte a l'autre levre. Rev Mens Med Chir. 1877;1:344.
Mazzola RF, Lupo G. Evolving concepts in lip reconstruction. Clin Plast Surg. Oct 1984;11(4):583-617. [Medline].
Bernard C. Cancer de la levre inferieure opera par un procede nouveau. Bull Mem Soc Chir Paris. 1853;3:357.
von Burow CA. Beschreibung einer neuen Transplantations-Methode (Methode der seitlichen Dreiecke) zum Wiedersatz verlorengenangener Teile des Gesichts. Berlin, Nauck; 1855.
Karapandzic M. Reconstruction of lip defects by local arterial flaps. Br J Plast Surg. Jan 1974;27(1):93-7. [Medline].
Gillies HD. Plastic Surgery of the Face. London: Oxford University Press; 1980.
Tobin GR. Lower lip and oral sphincter reconstruction with innervated depressor anguli oris flaps. Presented at: the 62nd Annual Meeting of the American Association of Plastic Surgeons. Colorado Springs, Colo; 1983.
Fujimori R. "Gate flap" for the total reconstruction of the lower lip. Br J Plast Surg. Jul 1980;33(3):340-5. [Medline].
Meyer R, Abul Failat AS. New concepts in lower lip reconstruction. Head Neck Surg. Jan-Feb 1982;4(3):240-5. [Medline].
Sadove RC, Luce EA, McGrath PC. Reconstruction of the lower lip and chin with the composite radial forearm-palmaris longus free flap. Plast Reconstr Surg. Aug 1991;88(2):209-14. [Medline].
Bakamjian VY. A two-stage method for pharyngoesophageal reconstruction with primary pectoral skin flap. Plast Reconstr Surg. 1965;36:173.
Blasius E. Handbuch der Akiurgie. Vol 2. Halle, Anton: 1839:426.
Burget GC, Menick FJ. Aesthetic restoration of one-half the upper lip. Plast Reconstr Surg. Nov 1986;78(5):583-93. [Medline].
Celsus AC. De medicina libri octo. Vol 7. Leipzig Teubner; 1859.
de Nonvilliers. De la methode autoplstique par pivotement appliquee a la restauration de levres. Bull Gen De Therap. 1863;65:257.
Delpech JM. Chirurgie clinique de Montpellier. Vol 2. Paris: 1823/1828:587.
Esser JF. Preservation of innervation and circulation supply in plastic restoration of uper lip. Ann Surg. 1934;99:101.
Freeman BS. Myoplastic modification of the Bernard cheiloplasty. Plast Reconstr Surg. 1958;21:453.
Ginestet G. Reconstruction de toute la levre inferieure par les lambeaux nasogeniens totaux. Revue d'Odontologie et Stomatologie. 1946;8:28.
Harii K, Omori K, Omori S. Successful clinical transfer of ten free flaps by microvascular anastomoses. Plast Reconstr Surg. Mar 1974;53(3):259-70. [Medline].
Hessler F. Commentarilii et annotationes in Susratae Ayurvedam. Erlangen Enke; 1855:12.
Kazanjian VH, Converse JM. Kazanjian and Converse's Surgical Treatment of Facial Injuries. 3rd ed. Baltimore: Lippincott Williams & Wilkins; 1972.
Kazanjian VH, Roopenian A. The treatment of lip deformities resulting from electric burns. Am J Surg. 1954;88:8884.
Lallemand L. Plaies a la face avec pertes de substance, guerie par l'application d'un lambeau detache des parties voisines. Arch Generales Méd. 1824;6:247.
Lisfranc. Cancer de la levre superieure; reparation presque complete. Paris: Gaz med de Paris; 1835:541.
Malgaigne JF, LeFort L. Manuel de medicine operatoire neuvieme edition. Paris, Alcan: 1889:215.
Millard DR. Lip-swich flaps for philtrum. In: Strauch B, Vasconez LO, Hall-Findlay EJ, eds. Grabb's Encyclopedia of Flaps. 2nd ed. Philadelphia: Lippincott-Raven; 1998:547-548.
Nelaton C, Ombredanne L. Les autoplasties. In: levres, joues, oreilles, tronc, membres. Paris: 1907:13.
O'Brien B. A muscle-skin pedicle for total reconstruction of the lower lip; case report. Plast Reconstr Surg. Apr 1970;45(4):395-9. [Medline].
Owens N. Compound neck pedicle designed for repair of massive facial defects. Plast Reconstr Surg. 1959;15:369.
Sedillot CE. Nouveau procede de cheiloplastie. Gas Med de Paris. 1848;3:7.
Senn N. A scalp face: A new plastic operation. NY Med J. 1903;77:1017.
Smith JW. The anatomical and physiologic acclimatization of tissue transplanted by the lip switch technique. Plast Reconstr Surg. 1960;26:40.
Stein SA. Laebedannelse (Cheiloplastik) udfort paa en ny methode. Hospitalsmeddelelson (Copenhagen). 1848;1:212.
Stone JS. Plastic surgery. In: Bryant JD, Buck AH, eds. American Practice of Surgery. Vol 4. NY: 1908:647.
Stranc MF, Robertson GA. Steeple flap reconstruction of the lower lip. Ann Plast Surg. Jan 1983;10(1):4-11. [Medline].
Tagliacozzi G. De curtorum chirurgie per institionem, libri duo. Venice, Bindonus; 1597.
Tobin GR. Lip reconstruction. In: Marsh JL, ed. Current Therapy in Plastic and Reconstructive Surgery: Head and Neck. Philadelphia: BC Decker; 1989:357.
Tobin GR, O'Daniel TG. Lip reconstruction with motor and sensory innervated composite flaps. Clin Plast Surg. Oct 1990;17(4):623-32. [Medline].
von Bruns V. Chirurgischer Atlas. In: Bildliche Darstellung der chirurgischen Krankheiten und der zu ihrer Heilung erforderlichen Instrumente, Bandagen und Operationen. II Abt: Kau-und Geschmaks-Organ. Tables XIII, XIV, X. 1857/1860.
von Bruns V. Handbuch der praktischer. Chirurgie; 1859.
Webster JP. Cresentic peri-alar-cheek excision for upper lip flap advancement with a short history of upper lip repair. Plast Reconstr Surg. 1955;15:434.
Webster RC, Coffey RJ, Kelleher RE. Total and partial reconstruction of the lower lip with innervated muscle-bearing flaps. Plast Reconstr Surg. 1960;25:360.
Further Reading
Keywords
lip reconstruction, cheiloplasty, labial reconstruction, oral sphincter reconstruction, oral continence restoration, facial reconstruction, face reconstruction, lip cancer, lip trauma, lip surgery, orbicularis oris, vermilion repair, vermilion, vermilion border, cross-lip flap, Abbe flap, Estlander flap, Gillies fan flap, Karapandzic flap, Bernard-Burow flap, cheek flap, perialar crescentic advancement flap, depressor anguli oris flap, nasolabial flap, regional flap, free flap, vermilionectomy, laser ablation, microstomia
