While freetissue transfer can provide an abundance of soft tissue. Feb 08, 2012 functional and cosmetic considerations must be included in any lip or chin reconstruction. Is it possible to reconstruct a lip that has been damaged. There were concomitant chin and mandible defects in three and four patients. Giles fa gillies fan flap for lower lip reconstruction. Lip reconstruction lip plastic surgery at the facial plastic surgery practice of dr. The new technique is an alternative for reconstruction of extensive upper lip defects in brachycephalic dogs and achieves satisfactory functional and cosmetic results. The newer format in clip files allows for quicker load and save times as it is a lighter format than. Is it possible to reconstruct a lip that has been damaged from lip biting. Reconstruction of a composite anterior mandibular defect with. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. The algorithm for lower lip reconstruction at our institution is illustrated in fig. A, b a 43yearold woman with a congenital vascular malformation of the lip and chin.
Conclusion human bites are potentially dangerous for their propensity in causing infections at the site of bite injury as well as posing a potential risk for transmission of systemic diseases. Aesthetic upper lip reconstruction with vermilion submucosalpedicle crosslip flap mutsumi okazaki, md, tsuyoshi hisatomi, md,1 shunji sarukawa, md2 tokyo, japan the localized. Total reconstruction of the upper lip using bilateral. Jun 30, 2010 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. During this period, one patient who underwent reconstruction with a myomucosal flap and. Flip pdf for mac makes it fast and easy for mac users to convert ordinary pdf files into mobile friendly eyecatching brochures or magazines with amazing pageflipping.
Lip reconstruction after tumor ablation world journal of plastic. 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. T2 n0 squamous cell carcinoma subtotal lower lip defect reconstructed with a karapandzic flap. Free pdf template to obtain and print at patternuniverse. Since the early nineteenth century, several techniques have been described for lower lip reconstruction. Original article fan flaps for cheiloplasty lower lip reconstruction. We present a case of lip reconstruction following a total resection of the upper lip. Lip reconstruction and aesthetics are the main focus of reconstructive, cleft and aesthetic surgeons. Other patients with subtotal or total lower lip defects may benefit from free gracilis muscle flap transfer. Sep 02, 2016 squamus cell carcinoma of the lip prophylactic neck dissection levels i, ii, iii, iv. The method is based on the principle introduced by stein and modified by estlander. A new tailored technique of vermilion repair in unilateral cleft lip.
Novel flaps for lip reconstruction skin therapy letter. What considerations must be made for lower lip reconstruction. Giles fa gillies fan flap for lower lip reconstruction case. Defects of more than two thirds of the lower lip with sufficient adjacent cheek tissue may be closed with the karapandzic for defects up to 80% or the bernardburow. Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction. Reconstruction of the lips requires careful attention to aesthetic and functional goals. Regardless of the depth or size, a successful lip reconstruction considers the five principles and the effect that the reconstruction has on the surrounding tissue. 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. With bigger defects, the resulting microstomy limits the proce.
Lip reconstruction is a challenging surgery but can produce good results in the right hands. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive. The lips are able to convey a myriad of minute expressions and emotions. While freetissue transfer can provide an abundance of. The lips along with the eyes are the two most expressive structures in our face. Dual free flap reconstructions can be employed to reconstruct these extensive intraoral and extraoral defects. Nov 07, 2016 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. James pearson serving hermosa beach, manhattan beach, redondo beach, torrance, palos verdes. Total lower lip reconstruction using free neurotendinofasciocutaneous anterolateral thigh composite flap. Rbcp total reconstruction of the lower lip with face flaps. The aesthetic or functional abnormalities that prompted revision surgery and the specific techniques.
Reconstruction of a composite anterior mandibular defect. Currently, the preferred reconstruction method for subtotal lower lip defects is a free flap orif this is not possiblelocal flaps. Upperlip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. This pdf is available for free download from a site hosted by medknow publications. Additionally, the lips are critical in eating and speaking. Lower lip carcinoma reconstruction using abbe estlander flap. This is more so when the resection is total and a complete lip has to be constructed. While nondynamic free tissue transfers provide adequate lower lip reconstruction, improved benefits may be obtained with innervated free muscle flaps. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge.
As a result of the relatively lower incidence of cancer, the reconstructive techniques for defects of the upper lip are fewer than lower lip. The use of a modified abbe island flap to reconstruct primary lip. Mar 10, 2020 lip reconstruction surgery in these cases typically uses skin grafts. In those patients who have had cancerous lesions, lip reconstruction. 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. Karapandzic flap and bernardburrowwebster flap for.
Upper lip reconstruction after mastcell tumorresection in a french bulldog was achieved by using a transposition flap from the nasalskinfold and an oral mucosal flap. While planning a lip reconstruction, as far as possible, dynamic. The total lip defects resulted from tumor resection n6, trauma n3, and noma n1. Outcomes following vy advancement flap reconstruction of. Tellioglu10, in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free microsurgical flap from the forearm radial flap, for total reconstruction of the lower lip. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive option to use is provided. These flaps of skin are added to the injured lip to restore it. Preschool music note coloring pages preschool children akctivitiys musical note pattern. Reconstructed lower lip 3 months postoperative i in modified fig. Lips free vectors, photos and psd downloads freepik. Upper lip reconstruction special considerations include presence of central structures cupids bow, philtrum in men, facial hair aids in hiding scars in men, nonhair. This study reports the use of innervated serratus anterior muscle free flaps for lip reconstruction in five patients. Various plans of lip reconstruction with switched flaps the patient was. The lips are very important aesthetic and functional unit of the face during articulation, mastication, smile, kissing and oral competence.
Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively. Fan flaps for cheiloplasty lower lip reconstruction. 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. Few authors have reported lower lip reconstruction with gracilis free flap. Any patient who has suffered trauma to their lips, for example a dog bite or laceration, must be treated immediately. Clinical study sensory recovery with innervated and. Free pdf template to download and print at patternuniverse. Stanislaw is an expert at lip reconstruction caused by these conditions. The lip file also supports rgb, cmyk, and hsv color, layer masks, filters, and other effects. When there is insufficient adjacent cheek tissue, a free flap may be used to close the defect. 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. We describe our approach to lip repair and present novel methods to maintain symmetry and function, and optimize cosmetic results. The muscles must be carefully repaired to avoid numbness in the lip.
We present 87 cases of total or neartotal lower lip reconstruction achieved with various methods. Functional and cosmetic considerations must be included in any lip or chin reconstruction. If there is a deep wound or hole in the lip, mucosa, or mucus membranes can also be used to fill in the area. Jan 23, 20 defects of more than two thirds of the lower lip with sufficient adjacent cheek tissue may be closed with the karapandzic for defects up to 80% or the bernardburow. Lip reconstruction may be required after trauma or surgical excision. Surgeons tend to place a single flap into a single wound during a single operation. When there is insufficient adjacent cheek tissue, a free. We report a case with a wide anterior oromandibular defect, involving soft and bony tissues, which was reconstructed using horizontal sliding osteotomies and an osteocutaneous forearm free flap. Reconstruction of skin cancer defect by sam naficy, md, seattle plastic surgeon. Aesthetic upper lip reconstruction with vermilion submucosal. Defects of more than two thirds of the lower lip with. Pdf on jan 23, 20, aditya sood and others published lower lip reconstruction. Lower lip reconstruction using the karapandzic technique performance of these f unctions can be compromised by struc tural defects of the lips that result from trauma, infections, congenital malformations, and tumoral lesions.
Larrabee, jr, md procedure selection for surgical reconstruction of lip defects depends on the location and. Larrabee, jr, md procedure selection for surgical reconstruction of lip defects depends on the location and extent of the defect. Use the printable outline for crafts, creating stencils, scrapbooking, and more. Total lower lip reconstruction using an innervated free gracilis muscle flap.
Vermilion defects the vermillion is the most prominent feature. Jagadeesh abstract department of plastic surgery, medical college, calicut. Karapandzic flap and bernardburrowwebster flap for reconstruction of the lower lip 159 to 23 of the length of the lower lip. Every day thousands of users submit information to us about which programs they use to open specific types of files. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer. 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. Lip reconstruction list of high impact articles ppts. Griffin and coauthors analyzed larger upper lip skin defects repaired with vy advancement flap reconstruction to identify defect characteristics that might predict the need.
Apr 15, 2019 tan o, kuduban sd, algan s, cinal h, barin ez. Functional lower lip reconstruction with the partial. Clip file when clip studio paint moved from the clip studio paint. A case of lower lip carcinoma in which reconstruction was performed with a lateral tongue flap based on the tongue dorsum. Aug 01, 2018 lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. Even small abnormalities can be apparent because of the prominent location. Lower lip reconstruction using the karapandzic technique. Lip reconstruction surgery in these cases typically uses skin grafts. The free flap technique will be a good option for young patients who have a defect involving the entire lower lip and mental region beyond the mentolabial. The etiology was squamous cell carcinoma in six patients, malignant melanoma in one, firearm injury in three and microstomia in two. Before the advent of freetissue transfer, large lip defects of over. Lip defects can be classified according to thickness of the defect ie, skin or mucosa only, fullthickness and overall size of the defect. General considerationsgeneral considerations for upper lip reconstruction, lower lip can be used, butfor upper lip reconstruction, lower lip can be used.
While planning a lip reconstruction, as far as possible, dynamic reconstruction should be attempted for restoration of facial expression, speech, and eating. 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. If there is a deep wound or hole in the lip, mucosa. Lip reconstruction connecticut stanislawmdstanislawmd. Clip file when clip studio paint moved from the clip studio paint format to the clip studio format in version 1. Lips serve a vital role in cosmetic beauty of the face and are an important functional structure for speech, chewing, and swallowing. Tellioglu10, in 1997, published a paper in which he suggested combining the depressor labii inferioris muscle with a free. The nerve and blood supply may also be affected if the defect is large. While we do not yet have a description of the lip file.
The method is based on the principle introduced by stein and modified by estlander, abbe, kazanjian, and converse, and seems to be especially valid in cases of older patients with redundant upper lip tissue. Lips are also common sites for occurrence of skin cancers. Gillies fan flap for lower lip reconstruction case report konrad wronski1, zbigniew maslowski2, leszek frackowiak3, janusz kaczor2 1department of surgical oncology, faculty of medicine, university of warmia and mazury in olsztyn, poland head of department. Basal cell cancers typically occur on the upper lip whereas squamous cell cancers occur on the lower lip. This article describes an alternative method for mandibular reconstruction following tumour ablation. All patients had squamous cell carcinoma of either the upper or lower lip. Pdf lip reconstruction poses a particular challenge to the plastic surgeon in that the. Lip reconstruction using a functioning serratus anterior. 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 reconstruction poses a particular challenge to the plastic surgeon in that the lips are the dynamic center of the lower third of the face. Jan 12, 2015 chapter 22 lip reconstruction introduction.