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Review
. 2018 May;32(2):69-74.
doi: 10.1055/s-0038-1645882. Epub 2018 May 14.

Simplifying Lip Reconstruction: An Algorithmic Approach

Kyle J Sanniec  1 , Jourdan A Carboy  1 , James F Thornton  1
Affiliations
Review

Simplifying Lip Reconstruction: An Algorithmic Approach

Kyle J Sanniec et al. Semin Plast Surg. 2018 May.

Abstract

The authors provide an overview of lip reconstruction after Mohs surgery based on the senior author's practice. Lip reconstruction offers unique challenges to preserve not only lip function but also aesthetics. Lip reconstruction must take into consideration the three anatomical layers that comprise the lip and defects that involve the mucosa, the muscle, the skin or more than one layer will help determine the modality of repair. The authors offer an algorithm based on defect location, tissue involvement, and severity of defect to simplify an often complex decision-making process.

Keywords: Ergotrid flap; Karapandzic flap; Lip Reconstruction; Mohs surgery; V-Y advancement; dermal matrices; full-thickness skin grafting; primary closure.

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Figures

Fig. 1
Fig. 1
Algorithm for lip reconstruction. (Reproduced with permission from Thornton J, Carboy J. Facial Reconstruction After Mohs Surgery. New York, NY: Thieme Publishers Inc.; 2018. www.thieme.com )
Fig. 2
Fig. 2
Skin only lip defect closed primarily.
Fig. 3
Fig. 3
Illustration of ergotrid to V-Y advancement flap continuum. ( A ) Defect in lateral third of lip with ergotrid flap markings. ( B ) Incision and rotation of an ergotrid flap to close defect with temporary suture to evaluate if tension free closure is possible. ( C ) Marking of the inferior incision to transition from an ergotrid rotation flap to a V-Y advancement flap if the defect is too large for an ergotrid flap to allow for tension free closure. ( D ) Inferior aspect of V-Y flap incised and advanced. ( E ) Closed incision demonstrating the V-Y advancement flap to cover the defect.
Fig. 4
Fig. 4
Patient marking for ergotrid flap.
Fig. 5
Fig. 5
Different patient, who underwent ergotrid flap.
Fig. 6
Fig. 6
Patient who underwent primary closure with wedge excision of full-thickness defect. Note that the vermillion is marked with a silk stitch prior to injection of local anesthetic.
See this image and copyright information in PMC

References

    1. Sanniec K, Thornton J F, Harirah M.Lip, cheek and scalp reconstruction and hair restoration Selected Readings Plast Surg 201811(R13)
    1. Weinberg T, Solish M, Fayez I, Murray C. Surface anatomy of the lip for the dermatologist. J Cutan Med Surg. 2014;18(03):200–202. - PubMed
    1. Burget G C, Menick F J. Aesthetic restoration of one-half the upper lip. Plast Reconstr Surg. 1986;78(05):583–593. - PubMed
    1. Gloster H M., Jr The use of second-intention healing for partial-thickness Mohs defects involving the vermilion and/or mucosal surfaces of the lip. J Am Acad Dermatol. 2002;47(06):893–897. - PubMed
    1. Leonard A L, Hanke C W. Second intention healing for intermediate and large postsurgical defects of the lip. J Am Acad Dermatol. 2007;57(05):832–835. - PubMed