Modified Bernard-Burow cheek advancement and cross-lip flap for total lip reconstruction

Subtotal lip reconstruction can be performed using local flaps such as the cross-lip flap or fan flap. Total lip reconstructive efforts usually are suboptimal in providing an adequate oral sphincter, an acceptable aesthetic result, or both. For total upper, lower, or extensive combined soft-tissue defects that include both lips, traditional methods of reconstruction include the use of regional flaps. More contemporary reconstructive efforts emphasize staged reconstruction with local tissue flaps using "like" tissue in a sequential fashion to achieve a successful outcome. We describe the reconstruction of total upper, lower, or extensive combined defects and report on 7 cases using a 2-staged method of reconstruction based on the modifications of the Bernard-Burow and Abbe flaps. The principle of esthetic units an intact modiolus and oral sphincter are emphasized to ensure excellent aesthetic and functional results.