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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

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Subcutaneous pedicle subunit flap for upper lip reconstruction.

H Kato¹, A Braun², M Horbrügger²

¹Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

|April 14, 2025

Summary

This summary is machine-generated.

This study presents a novel subcutaneous pedicle subunit flap technique for successful upper lip reconstruction after basal cell carcinoma removal. The method minimizes scarring and ensures functional and aesthetic outcomes for facial defect repair.

Keywords:

Facial reconstruction Facial unit Lip Skin cancer Subcutaneous pedicle subunit flap Surgery

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Area of Science:

Plastic Surgery
Dermatologic Surgery

Background:

Basal cell carcinoma (BCC) on the upper lip requires careful surgical reconstruction due to aesthetic and functional considerations.
Conventional reconstruction methods, like cheek or advancement flaps, can lead to noticeable scarring or contracture.
The upper lip's prominent location necessitates meticulous defect repair to preserve facial aesthetics.

Observation:

An 84-year-old patient with BCC underwent upper lip reconstruction using a local skin flap.
A subcutaneous pedicle subunit flap technique was employed for the reconstruction.
Postoperative assessment at 6 months showed minimal traction and symmetrical nasolabial folds.

Findings:

The subcutaneous pedicle subunit flap technique effectively reconstructed the upper lip skin defect.
Dividing the lip unit into subunits aligned sutures with relaxed skin tension lines, minimizing visible scarring.
The reconstruction resulted in no functional impairment of mouth opening or closing.

Implications:

This flap technique offers a valuable approach for upper lip reconstruction, improving aesthetic and functional results.
The method minimizes scarring and contracture, enhancing patient outcomes in facial defect repair.
Subunit division and alignment with relaxed skin tension lines represent a key advancement in reconstructive surgery for the lip area.