Lower lip reconstruction

Considerations

• • Indications

  • Neck dissection

    • Level 1-3 are the natural drainage

    • ND should include levels 1-4 for N disease 

  • Reconstructive options 

  • Primary closure

    • Loco-regional flaps 

      • Mucosal advancement 

      • Abbe (cross lip)

      • Estlander

      • Karapandzic

      • Bernard-Burow-Webster

      • Gilles fan (nasolabial transpositional) 

    • Free flap

  • Rules of thumb

    • Less than 1/2

      • Primary closure 

    • Less than 2/3

      • Abbe (oral commissioner spared)

        • 2014: The Abbe Flap for Upper Lip Reconstruction - Excellent concise technique paper that applies to both upper and lower lip reconstruction 

      • Estlander (oral commissioner involved)

      • 2013: A new technique for reconstruction of lower-lip and labial commissure defects: a proposal for the association of Abbe–Estlander and vermilion myomucosal flap techniques

      • Karapandzic (oral commissioner may be involved, works up to 3/4)

      • 2013: Lower Lip Reconstruction: Karapandzic Flap

    • Greater than 2/3 

      • Bernard-Burow-Webster

    • Near total / total

      • Free flap

• 2008: Lip Reconstruction

Preparation

Procedure

Sample operative report

Post-op

Pearls & Pitfalls

High-Yield

Links

• eMedicine - Lip Reconstruction Procedures

• UTMB - Lip Cancer and Reconstruction

• GBMC (Papel) - Lip Cancer: Treatment & Reconstruction

• Missouri - Lip reconstruction

• UVM - Lip reconstruction