The functional and aesthetic reconstruction of lip defects

Reconstruction of lip defects presents a challenge to the surgeon. Apart fr om attaining a good aesthetic result, preserving the function of the oral s phincter is an essential objective. A variety of techniques and modificatio ns of procedures for reconstructing lip defects have been reported in the l iterature. It is up to the surgeon to select the reconstruction procedure e nsuring optimum functional and cosmetic results, depending on the location, size, and depth of the defect. The division of the lips into aesthetic subu nits can prove very beneficial in designing lip reconstruction procedures. The upper lip is divided into three aesthetic subunits: two lateral subunit s and a median subunit,the philtrum. The lower lip constitutes a single sub unit. In this study, established reconstruction techniques are discussed an d a concept serving to facilitate the appropriate choice of technique is in troduced. This concept differentiates between vermilion defects on the one hand,and partial-thickness and full-thickness lip defects on the other hand . For the lower lip,the full-thickness defects are classified as defects in volving one-third, one-third to two-thirds of the lower lip width, and betw een two-thirds and complete loss of lip tissue. For the upper lip, a distin ction is made between isolated defects of the central and lateral subunits and combined defects of the central and lateral subunits. Important princip les of surgery and the advantages or disadvantages of different reconstruct ion techniques are discussed.