507 Total Lower Lip Reconstruction: A Systematic Review and Treatment Algorithm

Introduction To critically appraise the outcomes of different techniques described for total lower lip reconstruction in a retrospective study, where these factors were specifically documented. Method A comprehensive literature review was conducted over a 20-year period using Pudmed and EMBASE using the search terms “local”, “regional”, “functional”, “total lip reconstruction”. Data collected included: patient demographics, aetiology for lip reconstruction, reconstruction methods and outcomes (functional, aesthetic, complications). Results 204 patients from 28 studies were included. Squamous cell carcinoma of the lower lip (93.1%) was the most common cause for reconstruction. Of all the flaps, 67% were local flaps, 8.5% were regional flaps and 24.6% were free flaps. Most studies used a wide variety of objective and subjective outcome measures whereas only 4 used validated scoring systems to determine functional and aesthetic outcomes. Conclusions Despite a myriad of different techniques described, we are currently unable to determine a superior technique. Given the ultimate goal of reconstruction is to restore form and function, we recommend the use of a standardised recording of functional and aesthetic outcome measure to allow comparison and identification of best technique for lower lip reconstruction to optimise patients' outcomes.