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Updated: Apr 24, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Submandibular artery: bilobed platysma myocutaneous flap for total lower lip reconstruction
Ovunc Akdemir1, William C Lineaweaver2, Servet Celik3
1Department of Plastic, Reconstructive and Aesthetic Surgery, Ege University, Izmir, Turkey.
Background:
Lower lip reconstruction following cancer resection includes a variety of clinical and microsurgical options.
Objective:
We have developed a myocutaneous flap for full thickness reconstruction with a functioning muscle.
Technique:
In all patients, the submandibular artery was outlined using computerized tomographic angiography and Doppler. The flap was designed after resection. The first lobe was designed to fill the defect and was outlined 90° from the defect margin, with the submandibular artery in the center of the flap. A second lobe was then outlined 90° from the first lobe. The flap was raised along with the platysma muscle and artery, with the first lobe rotated to the lip and the second lobe inset into the first lobe site, permitting neck closure without skin redundancy.
Results:
From January to May 2012, 17 patients were treated with this flap, and all flaps survived. All of the patients had oral continence at sixteen months, and electromyography documented platysma function.
Conclusion:
The flap provides single-stage lower lip reconstruction with functional muscle.
