Functional lip reconstruction with a radial forearm free flap combined with a masseter muscle transfer after wide total excision of the chin

Total lower lip reconstruction was accomplished by combining a radial forea rm free flap with a masseter muscle transfer. The patient, who had T4 carci noma, had the entire lower lip resected including the depressor anguli oris muscle. A radial forearm flap was used to reconstruct the lower lip lining and the floor of the oral cavity. The right and left masseter musculofasci al flaps were elevated and transferred in the medial-superior direction, an d the peripheral margins of the flaps were sutured together. The lateral ma rgins of the flaps were then sutured to the orbicularis oris muscle of the upper lip. Good sphincter function was obtained more than 1 year after the operation, electromyography revealed almost normal mobility of the transfer red masseter muscles, and no sagging of the masseter muscle sling was obser ved. This procedure appears to be effective for the reconstruction of sphin cter function of the lower lip after wide excision of the entire chin.