V-Y advancement of a subcutaneous pedicle in vermilion lip reconstruction

We present three patients with lip cancer in whom the classic wedge excision would have resulted in an inordinate loss of tissue and possible compromise in shape and function. Without sacrificing the primary principle of adequately removing the cancer, the authors were able to excise the lesion and reconstruct the defect by means of a subcutaneous pedicle that might otherwise have been discarded with the usual wedge resection. There is a slight tendency for the healed skin flap to exhibit trapdoor scarring; however, in the older age group, in whom this technique has its greatest applicability, this has not been a permanent problem. This one-stage method of closing lip defects using subcutaneous pedicle flaps has the additional advantages of easy execution and minimal morbidity.