eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Lip Reconstruction: Workup

Author: Michael R Shohet, MD, Director, Facial Plastic and Reconstructive Surgery, Assistant Professor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Mount Sinai School of Medicine
Coauthor(s): Maurice M Khosh, MD, FACS, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons; Private Practice, Head and Neck Surgical Group; Attending Surgeon, Lenox Hill Hospital, Manhattan Eye, Ear and Throat Infirmary, Columbia Presbyterian Medical Center, St Luke's-Roosevelt Hospital Center, Beth Israel Medical Center
Contributor Information and Disclosures

Updated: Mar 10, 2008

Workup

Laboratory Studies

The laboratory tests that are required for lip reconstruction are those that would be necessary in any type of surgical intervention. Evaluation of coagulation profile, blood counts, blood chemistry, electrocardiography, chest radiography, and other specialized cardiac and pulmonary tests are indicated as appropriate for the age and medical conditions of each patient.

Imaging Studies

  • Most cases of primary lip reconstruction do not require special imaging. If any possibility exists that the underlying mandible is involved with a lower lip neoplasm, CT scanning with bony windows is indicated.
  • Consider MRI in those patients who present with preoperative hypoesthesia of the upper or lower lip. In this case, suspicion of infraorbital or submental nerve infiltration may be warranted. Extent of infiltration can certainly have an impact on the choice of extirpative technique.

Diagnostic Procedures

Diagnostic confirmation of cancer is often prudent prior to any extensive resection. Various biopsy techniques are available.

More on Lip Reconstruction

Overview: Lip Reconstruction
Workup: Lip Reconstruction
Treatment: Lip Reconstruction
Multimedia: Lip Reconstruction
References
Further Reading

References

  1. Karapandzic M. Reconstruction of lip defects by local arterial flaps. Br J Plast Surg. Jan 1974;27(1):93-7. [Medline].

  2. Hwang K, Kim DJ, Hwang SH. Musculature of the pars marginalis of the upper orbicularis oris muscle. J Craniofac Surg. Jan 2007;18(1):151-4. [Medline].

  3. Gillies HD, Millard DR. The Principles and Art of Plastic Surgery. Boston, Mass: Little, Brown; 1957.

  4. Baker SR, Krause CJ. Pedicle flaps in reconstruction of the lip. Facial Plast Surg. 1984;1(1):61-8. [Medline].

  5. Burow CA. Verlorengeaganener Teile des Gesichts. In: Berscheisung einer neuen transplantations methode zum wedersatz. Nauck: Berlin; 1855.

  6. Converse JM, Wood-Smith D. Techniques for the repair of defects of the lips and cheeks. In: Converse JM, ed. Reconstructive Plastic Surgery: Principles and Procedures in Correction, Reconstruction and Transplantation. 2nd ed. Philadelphia, Pa: WB Saunders; 1977.

  7. Jeng SF, Kuo YR, Wei FC, Su CY, Chien CY. Total lower lip reconstruction with a composite radial forearm-palmaris longus tendon flap: a clinical series. Plast Reconstr Surg. Jan 2004;113(1):19-23. [Medline].

  8. Larrabee WF, Sherris DA. Principles of Facial Reconstruction. Philadelphia, Pa: Lippincott-Raven; 1995.

  9. Luce EA. Carcinoma of the lower lip. Surg Clin North Am. Feb 1986;66(1):3-11. [Medline].

  10. Shohet MR, Khosh MM. Lip Reconstruction. In: Buchen DR. Skin Flaps in Facial Reconstruction. 1. New York: Mcgraw-Hill Companies, Inc; 2007:127-147.

  11. Zide B. Deformities of the lips and cheeks. In: McCarthy JG. Plastic Surgery. Vol 3. Philadelphia, Pa: WB Saunders; 1990.

Further Reading

Shohet MR, Khosh MM. Lip Reconstruction. In: Buchen DR, ed. Skin Flaps in Facial Reconstruction. 1st ed. New York: Mcgraw-Hill Companies, Inc; 2007:127-147.

Keywords

lip reconstruction, cheiloplasty, lip surgery, lip plastic surgery, lip carcinoma, lip cancer, lip defect, traumatic lip defect, neoplastic lip defect, fan flap, Karapandzic flap, Gillies fan flap

Contributor Information and Disclosures

Author

Michael R Shohet, MD, Director, Facial Plastic and Reconstructive Surgery, Assistant Professor, Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, Mount Sinai School of Medicine
Michael R Shohet, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, and Minnesota Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Maurice M Khosh, MD, FACS, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons; Private Practice, Head and Neck Surgical Group; Attending Surgeon, Lenox Hill Hospital, Manhattan Eye, Ear and Throat Infirmary, Columbia Presbyterian Medical Center, St Luke's-Roosevelt Hospital Center, Beth Israel Medical Center
Maurice M Khosh, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Triological Society
Disclosure: Nothing to disclose.

Medical Editor

Paul S Nassif, MD, FACS, Consulting Surgeon, Facial Plastic and Reconstructive Surgery, Spalding Drive Cosmetic Surgery and Dermatology
Paul S Nassif, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and California Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Dominique Dorion, MD, MSc, FRCSC, Program Director and Division Chair, Professor of Surgery, Division of Otolaryngology, University of Sherbrooke, Canada
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Advanced Headache Intervention Consulting fee Consulting; Covidien Corp Consulting fee Consulting

 
 
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