Chin IX: Unusual Soft Tissue Problems of the Lower Face

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.

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Revisiting the value of the ‘bandoneon’ flap for lower lip reconstruction: a report of two cases and outcome

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa082 ◽

2020 ◽

Vol 2020 (5) ◽

Author(s):

John M Le ◽

Sherry S Collawn

Keyword(s):

Squamous Cell Carcinoma ◽

Soft Tissue ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Sensory Function ◽

Local Flaps ◽

Lower Lip ◽

Lip Reconstruction ◽

Common Skin

Abstract Mild- to moderate-sized lip defects that affect one- to two-thirds of the total lip length often require that utilization of local soft tissue rearrangement in order to re-establish lip anatomy, function and esthetics. The use of local flaps in lip reconstruction often follows oncologic resection of common skin malignancies including basal cell carcinoma and squamous cell carcinoma. When considering the types of flaps to use for lip defects of one- to two-third total length, a variety of flaps designs have been described, each with its benefits in drawbacks. In this article, we reintroduce the use and value of the bilateral mucomyocutaneous ‘bandoneon’ flaps for lower lip reconstruction in two of our patients. When compared with other flap designs, it can be used as a single-stage procedure with a very good esthetic outcome, minimal to no microstomia and preservation of lip competence and sensory function.

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The hybrid concept in lip reconstruction

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202054 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1183 ◽

Cited By ~ 1

Author(s):

Badr M. I. Abdulrauf

Keyword(s):

Lower Lip ◽

Lip Reconstruction ◽

Standard Methods ◽

Cancer Resection ◽

Hybrid Concept ◽

Significant Size ◽

Similar Kind ◽

Reconstructive Techniques ◽

Abbé Flap ◽

Lip Defect

Local tissues are best suited for lip reconstruction. The defect following cancer resection is often significant where standard methods are often suboptimal. Here we are presenting 3 such cases. Case 1, a 65 years old male post squamous cell carcinoma (SCC) resection with 50% defect of lower lip and a commissure, reconstructed with Estlander flap and a unilateral Karapandzik flap on opposite side. Case 2, a 35 years old male had a similar kind of defect, reconstructed with Estlander flap and step-plasty on opposite side. Case 3, a 70 years old female with 80% central lower lip defect post SCC resection, was reconstructed with bilateral Karapandzik flaps and an Abbe flap. Considering the significant size defect, all cases healed quite satisfactorily. They maintained their oral competence with negligent microstomia. The hybrid principle of combining various reconstructive techniques is highly recommended for major lip defects.

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P.308 Lower lip reconstruction using the Abbe flap in a squamous cell carcinoma case

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/s1010-5182(06)60813-5 ◽

2006 ◽

Vol 34 ◽

pp. 210

Author(s):

R. Amaral Mendes ◽

S. Evelhoch

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Lower Lip ◽

Lip Reconstruction ◽

Squamous Cell Carcinoma Case ◽

Abbé Flap

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Longitudinal study of cephalometric soft tissue profile traits between the ages of 6 and 18 years

The Angle Orthodontist ◽

10.2319/041513-291.1 ◽

2013 ◽

Vol 84 (1) ◽

pp. 48-55 ◽

Cited By ~ 29

Author(s):

Robert T. Bergman ◽

John Waschak ◽

Ali Borzabadi-Farahani ◽

Neal C. Murphy

Keyword(s):

Soft Tissue ◽

Class I ◽

Profile Angle ◽

Lower Lip ◽

Lower Face ◽

Facial Profile ◽

Face Height ◽

Nasolabial Angle ◽

Soft Tissue Profile ◽

Growth And Change

ABSTRACT Objective: To study the longitudinal changes in 19 soft tissue cephalometric traits (according to the Bergman cephalometric soft tissue facial analysis). Materials and Methods: Cephalograms and photographs of 40 subjects (20 male, 20 female, from the Burlington Growth Centre) that were obtained at ages 6, 9, 12, 14, 16, and 18 years were used. Subjects were orthodontically untreated whites and had Class I dentoskeletal relationships (ideal overjet and overbite). Images were obtained with the lips in a relaxed position or lightly touching. Results: Three groups of soft tissue traits were identified: (1) traits that increased in size with growth (nasal projection, lower face height, chin projection, chin-throat length, upper and lower lip thickness, upper lip length, and lower lip–chin length); (2) traits that decreased in size with growth (interlabial gap and mandibular sulcus contour [only in females]); and (3) traits that remained relatively constant during growth (facial profile angle, nasolabial angle, lower face percentage, chin-throat/lower face height percentage, lower face–throat angle, upper incisor exposure, maxillary sulcus contour, and upper and lower lip protrusion). Conclusion: Current findings identify areas of growth and change in individuals with Class I skeletal and dental relationships with ideal overjet and overbite and should be considered during treatment planning of orthodontic and orthognathic patients.

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Upper lip reconstruction post major cancer resections using the hybrid concept

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202535 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1347

Author(s):

Badr M. I. Abdulrauf

Keyword(s):

Cancer Surgery ◽

Central Unit ◽

Upper Lip ◽

Additional Advantage ◽

Lower Lip ◽

Lip Reconstruction ◽

Hybrid Concept ◽

Upper Lip Reconstruction ◽

Abbé Flap ◽

Standard Techniques

Major defects of the upper lip due to cancer surgery are relatively less common compared to lower lip. Standard techniques such as Karapandzic’s are capable of reconstructing up to fifty percent of the lip otherwise microstomia and oral incompetence may result. The upper lip has few aesthetic characteristic details due to the philtrum, its columns and cupid’s bows. Here we are proposing incorporation of an abbe flap to reconstruct the central unit of upper lip, associated with Karapandzic flaps from both sides. Use of a lip sharing concept has an additional advantage of producing harmony to the reconstructed region, and avoidance of crowding phenomena to the lower lip.

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