Vermilion Reconstruction with Genital Mucosa

Abstract

Functional and aesthetical reconstruction, especially of the upper lip after ablative tumor surgery, can be very challenging. The skin of the lip might be sufficiently reconstructed by transpositional flaps from the nasolabial or facial area. Large defects of the lip mucosa, including the vestibule, are even more challenging due to the fact that flaps from the inner lining of the oral cavity often lead to functional impairments. We present a case of multiple vermilion and skin resections of the upper lip. At the last step, we had to resect even the whole vermilion mucosa, including parts of the oral mucosa of the vestibule, leaving a bare orbicularis oris muscle. To reconstruct the mucosal layer, we used a mucosal graft from the labia minora and placed it on the compromised lip and the former transpositional flaps for the reconstructed skin of the upper lip with very good functional and aesthetic results.

Fig. 1.

Aspect after the primary reconstruction of the upper lip using 2 transpositional flaps.

Fig. 2.

Outline of the harvesting area of the free mucosa grafts from the labia minora.

Fig. 3.

Intraoperative aspect of the free mucosa graft. Note the pale appearance of the transplant.

Fig. 4.

Appearance of the healed mucosal graft. The pale aspect has resolved, and the contour of the cupid bow is good. The skin flaps have to be thinned further.