Introduction: The lips carry a major role in speech articulation, facial features, deglutition, aesthetic look of and oral competence. Lip Reconstruction is of great challenge to the surgeon. It needs a great attention to the precise details of the lip anatomy.
Many Surgical procedures have been used to reconstruct the lip, however, Reconstruction of the aesthetic appearance and function of the lips require the replacement of the defective tissues with similar quality of a functioning tissue. These goals are difficult to be achieved large-sized lip defects. Classical flaps and their variations have been described and modified during the 19th century. In this study the author developed a new surgical technique for treatment of major upper lip defects.
Patients and Methods: This study was carried out on 20 patients presented with large upper lip defects, 15 cases were post tumor excision and five cases were post traumatic. Reconstruction was done using dermal-fat flap, muco-buccal flap and muscle transfer to achieve a good cosmetic and functioning upper or lower lip.
Results: As regard aesthetic results, the satisfaction rate as regard the alethic appearance and lip functions, was excellent in 12 patients (60%), and good in 8 patients (40%), but there was no case with bad results. Flap survival was excellent (100%) in all cases without any partial or total loss. As regard EMG study and two point discrimination tests, all cases showed very good motor and sensory functions, with all muscles functioning very well.
Conclusions: The combination of dermal-fat flap, muco-buccal flap, and muscle transfer is a very good reconstructive technique for extensive upper defects. We consider that, the procedure is ideal for reconstruction of major upper lip defects.
Level of Evidence: Level IV, therapeutic study.