Functional support for flap reconstruction of the lower lip and mandible

A case of functional support for distant flap reconstruction of the entire lower lip and mandibular symphysis following resection of an aggressive recurrent basal cell carcinoma of the lip is presented. Resection of the entire lower lip and mandibular symphysis includes loss of the orbicularis oris and attached muscles of the modiolus as well as the buccinator and masseter muscles. Without the support of these muscles, control of saliva as well as solid and liquid food is lost and articulation is hampered. In this case, fasciae latae strips attached to distally transected temporalis muscle tendons were tunneled bilaterally into the lower lip and chin area, which had been previously reconstructed with deltopectoral and pectoralis major musculocutaneous flaps.