Lower Lip Complications: Myth or Reality? A Case-Control Study on Sensory Outcomes After Buccal Mucosa Grafting

To evaluate sensory outcomes following lower lip graft harvesting in pediatric patients undergoing urethral reconstruction, with specific focus on mental nerve safety.

This case-control study included patients who underwent buccal mucosa harvesting from the lower lip between 2000 and 2023. Neurosensory testing involved tactile threshold measurement using Semmes-Weinstein monofilaments and thermal discrimination using a standardized temperature test. Age-matched male controls without neurological deficits, prior oral surgery, or intraoral lesions were also evaluated. All participants were assessed for subjective complaints related to the donor site.

Among 53 eligible patients, 21 were available for objective testing. No patients reported sensory disturbances, oral dysfunction, or cosmetic concerns. Mean Semmes-Weinstein thresholds were similar in the patient (2.21 ± 0.50) and control (2.16 ± 0.39) groups (P >.05). All subjects correctly identified thermal stimuli. No visible donor site deformities or functional limitations were observed.

Lower lip mucosal graft harvesting appears to be a safe technique for pediatric urethral reconstruction, with no evidence of mental nerve injury or sensory impairment. When performed with meticulous dissection and atraumatic technique, the lower lip remains a viable donor site.