Andrew J Kaufman1. 1. Center for Dermatology Care, Thousand Oaks, California 91360, USA. akaufman@vcnet.com
Abstract
BACKGROUND: Principles of aesthetic reconstruction recommend repair within cosmetic units with tissue of similar color, texture, and thickness. Because of the central facial location and primary functional and aesthetic importance of the lips, successful repair is critical in this location. Numerous procedures to reconstruct the lip have been reported; however, many result in a significant decrease in the oral aperture as well as dysesthesias, limitation of mobility, and significant scarring. OBJECTIVE: The purpose of this study was to describe a reconstructive option that repairs with skin of similar characteristics and avoids crossing into adjacent cosmetic subunits or sacrifice of normal skin or muscle. The proposed procedure is able to repair surgical defects up to 40% of the vermilion width in one stage and minimize the risk of nerve damage, scarring, or functional impairment. METHODS: The bilateral vermilion rotation flap permits repair within cosmetic subunits, repairs with skin of identical surface characteristics, and avoids surgery to the adjacent cutaneous or muscular portions of the lip. By keeping the pedicle intact, injury to neurovascular structures is minimized. RESULTS: The procedure provides an excellent repair for selected defects of the vermilion lip by following guidelines for optimum aesthetic and functional repair (i.e., repair within cosmetic subunits using skin of identical characteristics while avoiding trauma to the uninvolved cutaneous lip or orbicularis oris). CONCLUSION: The bilateral vermilion rotation flap is a useful technique for repair of surgical defects on the vermilion lip. It avoids unnecessary sacrifice of cutaneous or muscular lip tissue and provides an excellent cosmetic and functional result.
BACKGROUND: Principles of aesthetic reconstruction recommend repair within cosmetic units with tissue of similar color, texture, and thickness. Because of the central facial location and primary functional and aesthetic importance of the lips, successful repair is critical in this location. Numerous procedures to reconstruct the lip have been reported; however, many result in a significant decrease in the oral aperture as well as dysesthesias, limitation of mobility, and significant scarring. OBJECTIVE: The purpose of this study was to describe a reconstructive option that repairs with skin of similar characteristics and avoids crossing into adjacent cosmetic subunits or sacrifice of normal skin or muscle. The proposed procedure is able to repair surgical defects up to 40% of the vermilion width in one stage and minimize the risk of nerve damage, scarring, or functional impairment. METHODS: The bilateral vermilion rotation flap permits repair within cosmetic subunits, repairs with skin of identical surface characteristics, and avoids surgery to the adjacent cutaneous or muscular portions of the lip. By keeping the pedicle intact, injury to neurovascular structures is minimized. RESULTS: The procedure provides an excellent repair for selected defects of the vermilion lip by following guidelines for optimum aesthetic and functional repair (i.e., repair within cosmetic subunits using skin of identical characteristics while avoiding trauma to the uninvolved cutaneous lip or orbicularis oris). CONCLUSION: The bilateral vermilion rotation flap is a useful technique for repair of surgical defects on the vermilion lip. It avoids unnecessary sacrifice of cutaneous or muscular lip tissue and provides an excellent cosmetic and functional result.