Lower face reconstruction using a neurosensory osteocutaneous radial forearm flap and Webster modification lip repair

An innervated bipaddled osteocutaneous radial forearm free flap was combined with a Webster modification lip repair to successfully reconstruct in one stage the lower face following a devastating shotgun injury with loss of the anterior mandible, floor of the mouth, full-thickness chin, and subtotal lower lip. In addition to a pleasing aesthetic appearance with restoration of facial contour, the patient had a sensate flap with intelligible speech and no problems with drooling or mastication. This approach to a most complex reconstructive problem is technically feasible with a satisfactory aesthetic and functional outcome.