PMID: 9523616Apr 2, 1998Paper

Staged sequential reconstruction of a total lower lip, chin, and anterior mandibular defect

Annals of Plastic Surgery
J C YuenK Shewmake

Abstract

The combination of a total lower lip, chin, and anterior mandibular defect following cancer resection is an extremely complex problem that requires a sequence of operations to optimize functional and aesthetic results. One patient is presented in whom the defect was reconstructed with a free fibular flap followed by a series of ancillary procedures using both modern and traditional techniques. At the time of tumor ablation, the through-and-through oromandibular defect was reconstructed with a fibular osteocutaneous flap. The lower lip and gingivolabial sulcus was reconstructed later with a tongue flap. Tissue expansion was subsequently used to replace the fibular skin with expanded submental hair-bearing skin. A polyethylene implant was added later to the fibular bone for chin augmentation. Subsequently the lower lip was supported with a tendinous graft suspended to the anterior masseter bilaterally. Lastly, the vermilion border was elevated by removing a rim of the tongue flap and covering the secondary wound with a full-thickness skin graft. At the end of the reconstructive procedures, lip seal and oral aperture were good with no drooling and excellent speech.

Citations

Aug 5, 2014·Oral and Maxillofacial Surgery Clinics of North America·Robert A Strauss, Nicholas J Kain
Dec 21, 2000·British Journal of Plastic Surgery·F C WeiC T Liau
Dec 20, 2007·Oral and Maxillofacial Surgery Clinics of North America·Daniel Buchbinder, Hugo St-Hilaire
Mar 27, 2012·The Journal of Craniofacial Surgery·Andreas GravvanisNick Katsikeris
Mar 10, 2015·Plastic and Reconstructive Surgery. Global Open·Amin Rahpeyma, Saeedeh Khajehahmadi

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