The Gillies Fan flap is a single-stage composite rotational-advancement flap for reconstruction
of medium to large full thickness lower lip defects. It can be thought of as an extension
of the Estlander flap. It is nourished by a narrow superiorly-based pedicle of the
superior labial artery. Mobilized tissue includes adjacent lower lip tissue as well
as tissue from the opposing lateral lip. The oral commissure is distorted with use
of this technique, and sometimes requires a second stage for refinement using a commissureplasty,
discussed elsewhere in this issue. This flap is unique when compared with other reconstructive
modalities of the lip because it requires a full thickness incision through the lip,
thereby resulting in division of neurovascular and muscular structures, and as such
has largely been replaced by the Karapandzic flap, which maintains the radial neurovascular
supply, better preserving functions of the lip. This is accomplished by making incisions
through mucosa and skin only, rather than full thickness as described herein. The
Gillies fan flap can also be utilized using the MacGregor modification depending on
the scenario.
Keywords
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Publication history
Published online: January 06, 2020
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