Lip Reconstruction by Double Layer and Double Flap New Combination Technique: A Case Series

Area of Science:

• Plastic Surgery
• Oral and Maxillofacial Surgery
• Reconstructive Surgery

Background:

• Traditional lip reconstruction methods like primary closure and free flap transfer have limitations.
• Previous techniques, such as Cheek's skin flap, primarily addressed portions of the lip defect.

Purpose of the Study:

• To present a comprehensive reconstructive method for complex lip defects using the Goldstein-Robotti technique and a buccinator flap.
• To evaluate the functional and aesthetic outcomes of this double-layer technique for extensive lip and perioral muscle reconstruction.

Main Methods:

• Utilized the Goldstein-Robotti technique for vermillion reconstruction and a split buccinator flap for the cutaneous lip and perioral muscles.
• Employed soft tissue blunt dissection to minimize injury to facial nerves and vessels, ensuring flap viability and sensitivity.
• Demonstrated flap pedicle options based on internal maxillary artery branches or contralateral facial vessels for cases with compromised vascular supply.

Main Results:

• Successfully reconstructed various upper and lower lip defects, including the commissure, in six patients following ablative surgery.
• Achieved satisfactory functional and aesthetic results, characterized by similar tissue texture, and static and dynamic symmetry.
• The technique proved feasible even after neck dissection with ligated facial vessels.

Conclusions:

• The described double-layer technique using the buccinator flap offers a viable solution for extensive lip defects, including those involving the modiolus.
• This reconstructive approach provides excellent functional and aesthetic restoration, preserving lip sensitivity and symmetry.