Outcomes following vy advancement flap reconstruction of. 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. 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. Lip reconstruction connecticut stanislawmdstanislawmd. 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. Reconstruction of oncologic defects of the eyelid, lips and ear. 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. How to merge pdfs and combine pdf files adobe acrobat dc. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive option to use is provided. The two main techniques for reconstructing these defects employ either reconstruction with local tissue or freetissue transfer. With this modification, it is no longer necessary for the lateral margins of resection to extend beyond the commissure for technical purposes, and the shape of the resection does not have to be rectangular. In addition to the clear immediate need for soft tissue coverage, there is. One of the latest techniques advocated for total lower lip reconstruction is thegate flap described by fujimori in 1980 3.
Original article autologous fat grafting to correct lip. Facial fillers are an important nonsurgical modality in the management of lip defects. The number and variety of technics available for lip reconstruction has suggested to some authors that no method is ideal. Rearrange individual pages or entire files in the desired order. Seven useful surgical approaches are discussed, and an algorithm to assist in deciding which reconstructive. Original article aesthetic reconstruction of philtrum using deepidermized scar flap in secondary unilateral cleft lip ying xia1,2, qingqing fang 2,3, xiaofeng wang, wanyi zhao 2,3, weiqiang tan 1department of plastic surgery, shaoxing peoples hospital, shaoxing hospital of zhejiang university, shaoxing. We present a novel approach to extract high quality lip shapes bottom from just monocular video footage top based on a learned. 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. We describe a case of squamous cell carcinoma of lower lip in a. The lips are able to convey a myriad of minute expressions and emotions. Lower lip carcinoma reconstruction using abbe estlander flap. Total lower lip reconstruction is an extremely challenging problem. Corrective 3d reconstruction of lips from monocular video.
In fact, excellent results can be obtained under proper circumstances by. The split orbicularis myomucosal flap for lower lip reconstruction. These flaps of skin are added to the injured lip to restore it. 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. The aesthetic or functional abnormalities that prompted revision surgery and the specific techniques. Eyelid reconstruction, reconstruction of ear, reconstruction of lips. Larrabee, jr, md procedure selection for surgical reconstruction of lip defects depends on the location and extent of the defect. Click, drag, and drop to reorder files or press delete to remove any content you dont want. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal. The nerve and blood supply may also be affected if the defect is large. 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.
To treat lip tissue insufficiency, a forkshaped head cannula was used. Various applications of chondrocutaneous composite grafts in. A cleft palate refers to the roof of your mouth with or without. Apr 18, 2020 lip reconstruction surgery in these cases typically uses skin grafts. Improvement in oral competence, articulation, facial expression, and aesthetics can be achieved by augmentation of subdermal volume in areas of volume loss. Apr 15, 2019 lip reconstruction is driven by restoration or preservation of function and aesthetics. Various applications of chondrocutaneous composite grafts in secondary cleft lip nose patients meltem ayhan, metin gorgu, bulent erdogan,1 zeynep aytug, esin aksungur, ozlem sy. Lip reconstruction list of high impact articles ppts. The lips along with the eyes are the two most expressive structures in our face. Feb 08, 2012 functional and cosmetic considerations must be included in any lip or chin reconstruction. Become familiar with the wide variety of techniques available for reconstruction and their appropriate application.
Visor flap for lower lip reconstruction introduction the lip plays an essential role in deglutition, articula tion and facial expression. Functional and cosmetic considerations must be included in any lip or chin 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. The 3d reconstruction of realistic faces has prevailed a topic of interest 1,2,12.
Surgical technique the split orbicularis myomucosal flap for. Patients with such defects are frequently left with substantial functional impairment and disability. Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. Primary closure of the lip is the simplest technique for small defects. The reconstruction of the lips following the tumor ablation with abbe flap or its modifications may not be always satisfactory because it leaves parallel scars extending to the free vermilion margin, a trapdoor deformity and leave a cleft lip like appearance. 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 muscles must be carefully repaired to avoid numbness in the lip. However, they ignore the rolling nature of the inner contour and thus sacri. Jan 12, 2015 chapter 22 lip reconstruction introduction. Facial fillers in lip reconstruction sciencedirect. Click add files and select the files you want to include in your pdf. 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. There are many conditions that could benefit from a lip reconstruction such as trauma, congenital deformities, removal of cancerous lesions, or paralysis of facial nerve. I contemporary lip reconstruction techniques are based on early work from the 1 9th century.
Lower lip reconstruction with nasolabial flap going back to basics. Modified gate flap for lower lip reconstruction springerlink. Casereportcaseseries bilateraltranspositionlipflaps. Fiftytwo patients with congenital cleft lip and ac quired lip atrophy underwent autologous fat grafting treatment from august 2012 to july 2017. Lower lip reconstruction using the karapandzic technique. Individual patient factors, such as previous operations, underlying comorbidities, compliance, and mechanisms for the wound defect, may affect choices of reconstruction. Their role in aesthetic balance, facial expression, speech, and deglutination is not replicated by any other. Surgical technique the split orbicularis myomucosal flap. During this period, one patient who underwent reconstruction with a myomucosal flap and.
You can merge pdfs or a mix of pdf documents and other files. Described for use in intraoral reconstruction of a soft palate defect kloop and schurter 1956 variants of flap design for temporary or definitive coverage of small defects conley 1966 correction of lip deformities guerrerosantos and reconstruction for treatment of electrical burns ortizmonasterio closure of palatal. This is more so when the resection is total and a complete lip has to be constructed. Corrective 3d reconstruction of lips from monocular video pablo garrido 1michael zollhofer.
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. 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. Pdf the abbe flap for upper lip reconstruction researchgate. 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. 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. Original article aesthetic reconstruction of philtrum using. Sep 02, 2016 squamus cell carcinoma of the lip prophylactic neck dissection levels i, ii, iii, iv. Patients underwent assessments at 2, 4, 6, 12, and 18 months postoperatively. Lip reconstruction can generate a considerable challenge to the plastic surgeon because of their role in aesthetic balance, facial expression, speech and deglutination. The division of the lips into aesthetic subunits can prove very beneficial in designing lip reconstruction procedures. Any patient who has suffered trauma to their lips, for example a dog bite or laceration, must be treated immediately. We present a case of lip reconstruction following a total resection of the upper lip. The upper lip is divided into three aesthetic subunits.
Aesthetic upper lip reconstruction with vermilion submucosal. Flaps described include websterbernard cheek advancement. Total reconstruction of the upper lip using bilateral. This technique has been modified and used in two patients. These defects range from mucosal only defects, skin only defects, and then a combination of skin and mucosal defect fig. Importance the reconstruction of cutaneous defects of the cheek and lip is a foundational topic for facial plastic and reconstructive surgeons. This discussion will focus on lip defects with significant tissue loss that require flap reconstruction.
Since the early nineteenth century, several techniques have been described for lower lip reconstruction. Lip fillers can serve as a standalone or adjunctive treatment for lip reconstruction. A total of 14 patients with a minimum fol lowup of 6 months. Gordon buck, during the civil war, was the first surgeon in the englishspeaking world to describe a cross lip reconstruction. Squamous cell carcinoma of the lower lip is frequent, and radical excision sometimes leads to complex defects. Additionally, the lips are critical in eating and speaking. While there exist a wide range of methods reconstructing a. Pdf 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 find, read and. Reconstruction of its lesions is very important and offers a unique challenge to the surgeon. The reconstruction of a subtotal to total lower lip defect, whether it be due to trauma or cancer resection, presents a significant challenge for the plastic and reconstructive surgeon.
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