Download - Lip Recontruction
Lip recontruction
Defect < 1/3 of lip simple excision with primary closure Defect 1/3 2/3 of lip Lip-switch (Abbe-Estlander) Johansson stepladder flap Defect > 2/3 of lip Gilles fan flap Bilateral advancement flaps Karapandzic Free radial forearm with palmaris longus tendon Large defects Webster or Bernard procedures using lateral nasolabial flaps with buccal advancement Aggressive and advanced-staged lesions Perineural spread should be performed at the time of resection. Potential biopsy of the mental nerve with a retrograde dissection in an attempt to obtain a negative margin should be considered With extensive perineural invasion, a drill-out of the mental nerve or hemimandibulectomy may be required
- Estlander flap is based laterally on the commissure - Abbe flap rotates a point medial to the commissure - Both rely on the labial artery and vein - Both can be superior or inferiorly based and can reconstruct defects up to 2/3 of the lip
Abbe flap
Estlander flap
Perialar crescentic advancement flap
Depressor anguli oris flap
Regional and free flaps
Vermilionectomy and laser ablation