The Use of Vastus Lateralis Muscle Flap for Functional Lip Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Oncology

Background:

• Total or near-total lip defects present significant reconstructive challenges.
• Static reconstruction methods often yield suboptimal functional and aesthetic results.
• Dynamic reconstruction using functional muscles is an emerging area with promising outcomes.

Purpose of the Study:

• To present successful cases of total and near-total lip reconstruction using vastus lateralis muscle.
• To evaluate the functional and aesthetic outcomes of this reconstructive technique.

Main Methods:

• Retrospective analysis of 3 patients (2 male, 1 female, aged 44-56) with extensive squamous cell carcinoma requiring lip resection.
• Innervated vastus lateralis muscle free flap transfer with facial artery and internal jugular vein anastomosis.
• Marginal mandibular branch of the facial nerve coaptation for reinnervation.
• Split-thickness skin grafting for flap surfaces.
• Evaluation using drooling scale, scar assessment scale, and electromyography.

Main Results:

• Successful single-stage reconstruction of near-total lower lip and partial upper lip defects in all patients.
• Achieved excellent oral sphincter competence without drooling in 2 patients.
• Demonstrated successful reinnervation of the vastus lateralis muscle at 9 months postoperatively.
• One patient experienced skin graft loss managed conservatively with successful muscle healing.

Conclusions:

• Innervated vastus lateralis muscle free flap is a reliable and effective method for lip reconstruction.
• This technique provides functional lip restoration, improving oral competence.
• The study highlights the potential of dynamic muscle transfer in complex lip defect reconstruction.