Reconstruction of partial-thickness vermilion defects with a mucosal V-Y advancement flap based on the orbicularis...

Repair of a large, trauma-induced partial-thickness vermilion defect is considered a challenging task. Ideally, such defects should be corrected by methods that use tissues similar in colour and texture to the normal vermilion. When the length of a defect is greater than half that of the vermilion and the width of the defect is greater than 1.5 cm, however, effective repair is not always achieved using the traditional mucosal V-Y advancement flap. In this article, a modified mucosal V-Y advancement flap containing the orbicularis oris muscle is described. This flap possesses the mobility sufficient to serve as the pedicle for the transfer and repair of large vermilion defects. Between August 2006 and January 2009 vermilion reconstruction using this modified flap was performed on eight patients, with satisfactory cosmetic and functional outcomes obtained in all cases. This simple and useful approach to vermilion reconstruction provides excellent outcomes with minimal injury to the donor site.