Search Results (4)

Background: When defects occur in the lips due to conditions such as lip cancer, it is essential to reconstruct them both functionally and aesthetically, given the vital roles that lips play in communication, nutrition, and overall appearance. Various flap techniques are available for lip reconstruction, and the surgical method should be chosen based on the location and extent of the defect. Methods: This article discusses two cases of successful lip reconstruction using a combination of the Abbe flap and additional flaps, tailored to the extent of the defects. In case 1, a 52-year-old female diagnosed with angiosarcoma underwent a wide resection of 1/3 to 2/3 of her upper lip. Reconstruction was performed using an Abbe flap combined with a perialar crescentic flap. In case 2, a 54-year-old male with squamous cell carcinoma had more than 2/3 of his lower lip excised. Although the Bernard–Burrow–Webster flap is typically used for such cases, the patient was reconstructed with an Abbe flap combined with a staircase flap, addressing the limitations of traditional methods. Results: Both reconstruction surgeries achieved excellent aesthetic and functional outcomes. In case 1, the combination of the Abbe flap and perialar crescentic flap provided the patient with a natural appearance and preserved lip functionality. In case 2, the Abbe flap and staircase flap technique effectively restored lip function while avoiding complications such as microstomia and surgical scars associated with more conventional methods. Conclusions: The findings underscore that using the Abbe flap in combination with the perialar crescentic advancement flap or staircase flap can effectively restore both the functional and aesthetic integrity of the lips, particularly in cases involving significant tissue loss. Full article

Background/Objective: Surgical treatment of extensive tumors of the lower lip generates important defects in its structure and functions. Over time, a multitude of reconstruction options for these defects have been imagined. Unfortunately, the majority involve the use of both local and regional flaps, which either lack labial structure or disorganize the oral commissures as nodal oral function points. We set out to design a new reconstruction method that is not burdened by any of the above disadvantages, starting from the necessity to reconstruct large lower lip defects by exclusively using local and/or regional labial flaps belonging only to the healthy upper lip and the remaining structures of the lower lip after surgical tumor removal. In this way, the tissues involved in lower lip reconstruction will have a 100% labial structure and, supplementarily, the remaining oral commissures will not be damaged. Method: This new reconstruction method is based on the original association of WY-plasty to reduce the size of the large primary defect until it becomes congruent with the Abbe–Sabattini cross-lip flap. Results: Applied in a personalized manner, impressive results were obtained in several patients with lip tumors affecting about one-half of the lower lip length and in whom oncological surgical ablation produced defects in more than two-thirds of it. Conclusions: This new method is characterized by functional oral advantages, and can be applied in a personalized way to only certain categories of patients. Other disadvantages are characteristic and specific of Abbe–Sabattini cross-lip flap plasty. Full article

Background: The reconstruction of midface skin defects represents a challenge for the head and neck surgeon due to the midface’s significant role in defining important facial traits. Due to the high complexity of the midface region, there is no possibility to use one definitive flap for all purposes. For moderate defects, the most common reconstructive techniques are represented by regional flaps. These flaps can be defined as donor tissue with a pedunculated axial blood supply not necessarily adjacent to the defect. The aim of this study is to highlight the more common surgical techniques adopted for midface reconstruction, providing a focus on each technique with its description and indications. Methods: A literature review was conducted using PubMed, an international database. The target of the research was to collect at least 10 different surgical techniques. Results: Twelve different techniques were selected and cataloged. The flaps included were the bilobed flap, rhomboid flap, facial-artery-based flaps (nasolabial flap, island composite nasal flap, retroangular flap), cervicofacial flap, paramedian forehead flap, frontal hairline island flap, keystone flap, Karapandzic flap, Abbè flap, and Mustardè flap. Conclusions: The study of the facial subunits, the location and size of the defect, the choice of the appropriate flap, and respect for the vascular pedicles are the key elements for optimal outcomes. Full article

When the editor asked me to write something related to the chin, I (B.M.Z.) told him I would like to concentrate on the soft tissue of the perioral and chin region, something previously not presented before in this Journal specifically or anywhere. Dr. Flores and I have chosen certain soft tissue cases of the lower face, each of which presents certain dilemmas. The reconstructive methods in each case are unique, previously not shown, and represent salvage from prior failures. Case 1 shows how an interior Abbe flap can be used for ipsilateral lip reconstruction. Case 2 shows how a large upper lateral lip elemental loss can be regained from cheek and not the lower lip. Cases 3 and 4 show how to regain proper white roll bulge and symmetry by overcorrection, then exact adjustment in a second stage. Case 5 shows how a failed chin/lip reconstruction can be salvaged to regain sulcus height and aesthetic unit reconstruction. Each case depicts unique reconstructive designs to produce an aesthetic final result. Full article