Survival of an upper lip aesthetic complex using arterial reanastomosis only

Venous congestion after microvascular replantation remains a formidable problem even under ideal circumstances. The patient reported is a young woman with a traumatically avulsed upper lip aesthetic complex. Blood flow was reestablished using microanastomosis of the labial artery, however, no veins of adequate size could be recovered. With systemic administration of heparin, allowing the flap to bleed freely in addition to the use of medicinal leeches, we were able to salvage an avulsed upper lip aesthetic complex with the use of a single arterial microanastomosis. This patient report exemplifies alternative methods used in dealing with venous inadequacy in a composite replant.