“Hammock” reconstruction of full-thickness excised lower lip: a case report

“Hammock” reconstruction of full-thickness excised lower lip: a case report A number of techniques have been described to reconstruct lower lip defects. A microsurgical total lower lip reconstruction was performed in a 48-year-old female patient affected by a squamous cell carcinoma of the lower lip. The patient underwent a wide lower lip resection and an immediate aesthetic and functional lower lip reconstruction. The lower lip was reconstructed with a composite radial forearm palmaris longus flap. The subcutaneous layer of the residual upper lip was undermined and palmaris longus tendon was transfixed to the paranasal portion of the orbicularis oris muscle, giving to the flap a good aesthetic “hammock” effect and achieving a nearly impairment free function. The use of a forearm free flap for lower lip reconstruction has previously been described, with poor functional results. We have described a different technique to inset and fix the flap using palmaris longus tendon: the suspension vector of the flap and the preservation of the residual orbicularis oris fibers seem to be of great importance to achieve a satisfactory functional recovery. We propose that the radial forearm free flap comprising palmaris longus tendon, inset and fixed with the described technique, may be a good alternative among the surgical options for full-thickness lower lip defects in order to achieve a satisfactory aesthetic and functional reconstruction. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

“Hammock” reconstruction of full-thickness excised lower lip: a case report

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Publisher
Springer-Verlag
Copyright
Copyright © 2009 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-009-0356-1
Publisher site
See Article on Publisher Site

Abstract

A number of techniques have been described to reconstruct lower lip defects. A microsurgical total lower lip reconstruction was performed in a 48-year-old female patient affected by a squamous cell carcinoma of the lower lip. The patient underwent a wide lower lip resection and an immediate aesthetic and functional lower lip reconstruction. The lower lip was reconstructed with a composite radial forearm palmaris longus flap. The subcutaneous layer of the residual upper lip was undermined and palmaris longus tendon was transfixed to the paranasal portion of the orbicularis oris muscle, giving to the flap a good aesthetic “hammock” effect and achieving a nearly impairment free function. The use of a forearm free flap for lower lip reconstruction has previously been described, with poor functional results. We have described a different technique to inset and fix the flap using palmaris longus tendon: the suspension vector of the flap and the preservation of the residual orbicularis oris fibers seem to be of great importance to achieve a satisfactory functional recovery. We propose that the radial forearm free flap comprising palmaris longus tendon, inset and fixed with the described technique, may be a good alternative among the surgical options for full-thickness lower lip defects in order to achieve a satisfactory aesthetic and functional reconstruction.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Dec 1, 2009

References

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