Additionally, the lips are critical in eating and speaking. Aesthetic upper lip reconstruction with vermilion submucosalpedicle crosslip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized cutaneous amyloidosis occurring on the upper lip of a 48yearold man was surgically treated andaestheticallyreconstructed with. Lip reconstruction poses a particular challenge to the plastic surgeon in that the lips are the dynamic center of the lower third of the face. General considerationsgeneral considerations for upper lip reconstruction, lower lip can be used, butfor upper lip reconstruction, lower lip can be used, but vice versa is avoided. In the second stage of the lip reconstruction, cross lip flap abbe was used to restore the symmetry and volume of the upper and lower lips figure 4. No gold standard in the reconstruction of both upper and lower lips has been established. The two main techniques for reconstructing these defects employ either. Lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. If there is a deep wound or hole in the lip, mucosa, or mucus membranes can also be used to fill in the area. A 49yearold male patient presented in june 2011, with a large ulcerating painful mass involving the right lip commisure and right half of the upper lip and right onethird of the lower lip extending inwards involving the underlying part of the inner buccal mucosa, preoperative wedge biopsy revealed an invasive grade ii squamous cell carcinoma. See the list of programs recommended by our users below. Aside from dermal fillers, other options include fat transfers and facial surgery lip augmentation. The authors provide an overview of lip reconstruction after mohs surgery based on the senior authors practice.
Even small abnormalities can be apparent because of the prominent location on the face. Total reconstruction of the upper lip using bilateral. Rbcp total reconstruction of the lower lip with face flaps. Lip reconstruction lip plastic surgery at the facial plastic surgery practice of dr. Address for correspondencechi mao, md, department of oral and. Lip reconstruction requires familiarity with the surface anatomy, underlying muscular anatomy, and neurovascular anatomy of the lower face. A lip file accompanies a sound file meant for spoken words in a mission. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer.
The cheek advancement flap can be modified in such a way as to achieve this. Large upper lip defects, including skin and muscle, can be reconstructed using this technique. The use of submental island flap for total lower lip reconstruction. In reconstruction of the upper lip, it is important to observe the principle of aesthetic units and subunits. Remember that you need to download a program to support a particular file type. Lip file extension can correspond to several not related file formats. The upper lip is divided into three aesthetic subunits. What links here related changes upload file special pages permanent link page. Martin et al 3 reported that plastic surgeons first choice for reconstruction of upper lip defects was the cheek advancement flap, followed by the abbe flap. Lip reconstruction may be required after trauma or surgical excision.
Karapandzic flap and bernardburrowwebster flap for reconstruction of the lower lip 159 to 23 of the length of the lower lip. Any reconstruction of the lips must include both functional and cosmetic considerations. By definition, the reconstruction of large lip defects is not easy, and some compromise must usually be accepted in the result. In those patients who have had cancerous lesions, lip reconstruction should be a part of the complete management of their treatment. Reconstruction of skin cancer defect by sam naficy, md, seattle plastic surgeon. With bigger defects, the resulting microstomy limits the procedure. It may be observed to affect upper lip movement more than lower lip movement. For normal appearance, lips should have symmetry between.
Griffin and coauthors analyzed larger upper lip skin defects repaired with vy advancement flap reconstruction to identify defect characteristics that might predict the need for revision surgery. Patients with such defects are frequently left with substantial functional impairment and disability. However, because dermal fillers are the least invasive option with very little recovery time needed, they are highly popular. The lips are able to convey a myriad of minute expressions and emotions. Elliot duyboys and the team at associated plastic surgeons understand that there are often many emotions that accompany a disfigurement or loss of physical attributes. Upper lip reconstruction special considerations include presence of central structures cupids bow, philtrum in men, facial hair aids in hiding scars in men, nonhairbearing flaps brought into hearbearing areas can be noticeable the upper lip is less important in oral competence more lower. Aesthetic upper lip reconstruction with vermilion submucosalpedicle cross lip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized cutaneous amyloidosis occurring on the upper lip of a 48yearold man was surgically treated andaestheticallyreconstructed with vermil. The aesthetic or functional abnormalities that prompted revision surgery and. Defect size alone cannot be used to predict the need for revision surgery.
To repair the large defect, we designed our own technique using combined 3 local flaps as described in the following sections. There are many reasons why this may happen to an individual and whether your needs stem from a congenital or genetic defect, trauma, disease or cancer. Upperlip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. With total or subtotal lip defects, unlike the former technique, the bernardburrowwebster flap is a good option for reconstruction. Their role in aesthetic balance, facial expression, speech, and deglutination is not replicated by any other. Accurate analysis of the defect and a thorough understanding of the anatomy and options for reconstruction will maintain the functional and aesthetic quality of this sensitive area. The abbe flap its use in single and double lip clefts. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. Lower lip reconstruction strategies patient had a lesion covering 90% of the lower lip that was reconstructed using the websterbernard technique and a tongue flap figure 7, table 1.
During this period, one patient who underwent reconstruction with a myomucosal flap and. The lip file also supports rgb, cmyk, and hsv color, layer masks, filters, and other effects the lip file was replaced by the. The aesthetic or functional abnormalities that prompted revision surgery and the specific techniques. Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction. Reconstruction of the lip commissure with upper and lower. The principle of lip defects involves reconstruc tion with the remaining or opposite lip but there are no existing studies that describe simultaneous reconstruction of both upper and lower lips. The cheek advancement flap can be modified in such a. Lip reconstruction connecticut stanislawmdstanislawmd. Lower lip reconstruction using the karapandzic technique. Cold war crisis is a tactical shooter and battlefield simulator video game developed by bohemia interactive studio. Any patient who has suffered trauma to their lips, for example a dog bite or laceration, must be treated immediately. Functional and cosmetic considerations must be included in any lip or chin reconstruction. This is more so when the resection is total and a complete lip has to be constructed.
Reconstruction of an aesthetically acceptable and functional upper lip requires a careful consideration of the transverse and vertical soft tissue, muscle, and skin deficiency. While we do not yet have a description of the lip file format and what it is normally used for, we do know which programs are known to open these files. The most common type of lip surgery is lip augmentationsometimes referred to as lip enhancement surgery. Upper lip reconstruction using a modified perialar crescentic. Full upper lip reconstruction is a challenging area, the problems are those related to the restoration of all anatomical structures of this esthetic unit. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. Clip file when clip studio paint moved from the clip studio paint format to the clip studio format in version 1.
Lip reconstruction list of high impact articles ppts. Lip reconstruction surgery in these cases typically uses skin grafts. The using of cervical and deltopectoral flaps in the. Become familiar with the wide variety of techniques available for reconstruction and their appropriate application. The karapandzic flap can be used to resurface up to neartotal defects of both the upper and lower lips, though superiorly based flaps for lower lip defects are. Not distorting the commissure is also desirable for upper lip reconstruction. The upper lip is composed of the philtrum and tubercle centrally, the paired philtral columns laterally, and the white roll of the vermiliocutaneous junction.
It is certainly possible to remove and reconstruct a damaged portion of the lip. Lip reconstruction can generate a considerable challenge to the plastic surgeon because of their role in aesthetic balance, facial expression, speech and deglutination. Aesthetically, facial units should be reconstructed with adequate tissue match in terms of colour and texture, aiming at symmetry as well as preservation of the apparent. Total lower lip reconstruction is an extremely challenging problem. Total reconstruction of the upper lip using bilateral nasolabial flaps, submental flap, and mucosa graft following complete resection for. Tellioglu10, in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free microsurgical flap from the. Lip extension, you will probably find most of them at this website. Total reconstruction of the upper lip using bilateral nasolabial. We report the case of an advanced squamous cell carcinoma involving both the upper lip, lower lip, left oral commissure and buccal area and simultaneous reconstruction with local flap coverage that, to the best of our knowledge, has never been reported.
Outcomes following vy advancement flap reconstruction of. In trauma, the reconstruction is also performed immediately after. Lip reconstruction is the process of maintaining oral competence, sufficient oral access and preservation of sensation after severe injury, burn or in case of lip cancer. Pdf lip reconstruction poses a particular challenge to the plastic surgeon in that the lips are the. Full upper lip reconstruction following cancer excision springerlink. A case report yuxing guo, md 1 chi mao, md1 1department of oral and maxillofacial surgery, peking university school and hospital of stomatology, beijing, china facial plast surg 2016. The use of submental island flap for total lower lip. Upper lip reconstruction using a modified perialar. Lip augmentation is performed several ways, depending on your desired outcome. In oncologic lesions and hemangioma resections, the reconstruction is usually performed under the same anesthetic or after a short period needed for confirmation of completeness of cancer resection. Various plans of lip reconstruction with switched flaps the patient was returned to the operating room where the flaps were separated and wider excision was obtained from the lower lip.
Lip retraction this is an abnormal pattern in which increased abnormal tone pulls the corners of the lips up and back. Depending on the size of the problem, lip deformities can usually be corrected in a very cosmetic fashion so that residual signs of the reconstruction are minimal. Griffin and coauthors analyzed larger upper lip skin defects repaired with vy advancement flap reconstruction to identify defect characteristics that might pre. Although many techniques use hairbearing flaps to repair large upper lip defects in men, few preserve orbicularis sphincter function. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive. In the upper lip, a subunit analysis is required for reconstructive planning of defects.
The muscles must be carefully repaired to avoid numbness in the lip. Patients usually present for lip reconstruction immediately following lip loss. Giles fa gillies fan flap for lower lip reconstruction. An external file that holds a picture, illustration, etc. The goals of lip reconstruction are normal appearance and normal function.
Defect of 30% of the upper or lower lip can be closeddefect of 30% of the upper or lower lip can be closed primarily great elasticity of. We have developed a new technique and successfully repaired a large defect in the upper lip of three men. Upper lip reconstruction after oncologic resection by a slid. Rapid, small movements of the lips during purposeful activity, such as lip seal. Any lesion that is present on the lip and enlarging could be a skin cancer, which needs to be investigated as soon as possible. Lip augmentation nashville, tn franklin lip augmentation. The lips along with the eyes are the two most expressive structures in our face. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures.
Reconstruction of the lip commissure with upper and lower lip fullthickness defects using submental and nasolabial flaps. Aesthetic reconstruction for large upper lip defects in. Karapandzic flap and bernardburrowwebster flap for. We present a case of lip reconstruction following a total resection of the upper lip. Upper lip reconstruction special considerations include presence of central structures cupids bow, philtrum in men, facial hair aids in hiding scars in men, nonhairbearing flaps brought into hearbearing areas can be noticeable the upper lip is less important in oral competence more lower lip tissue can be borrowed. Reconstruction of large upper lip skin defects with a vy subcutaneous tissue pedicle advancement flap is associated with a 47% revision rate, and when the defect involves the ala or vermilion, the revision rate is increased. Available techniques can also result in an unnatural appearance, because the entire upper lip is covered by a dense region of hair. Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively.
Functional and aesthetic reconstruction of a large upper lip defect. Is it possible to reconstruct a lip that has been damaged. Reconstructed lower lip 3 months postoperative i in modified fig. But there are other types of lip procedures as well. Pdf simultaneous total upper and lower lip reconstruction during. Pdf on sep, 2016, arthur charpentier and others published simultaneous total upper and lower lip reconstruction during a humanitarian surgical mission.
Psd files used by adobe photoshop as they are used as a project file which allows you to resume your work at a later time. The new technique is an alternative for reconstruction of extensive upperlip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results. Since the early nineteenth century, several techniques have been described for lower lip reconstruction. Lip reconstruction after tumor ablation world journal of plastic. Advanced squamous cell carcinoma involving both upper and. Primary closure of the lip is the simplest technique for small. These flaps of skin are added to the injured lip to restore it.
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