Research Article| Volume 31, ISSUE 1, P26-32, March 2020

Free flap reconstruction of the lip

  • Kevin S. Emerick
    Address reprint requests and correspondence: Kevin S. Emerick, MD, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 01224.
    Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
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Published:January 05, 2020DOI:
      Free tissue transfer is a critical tool for lip reconstruction. This section will discuss different aspects of free flap reconstruction. This type of reconstruction is primarily used for large skin and soft tissue defects typically involving greater than 80% of the lip. Both fasciocutaneous as well as muscular free flaps can be utilized for lip reconstruction. Free flaps can be utilized in nondynamic as well as dynamic types of reconstruction. When free flaps are utilized they often require significant revision and tailoring in the months following the initial reconstruction. Free flaps are excellent at providing the necessary skin and soft tissue reconstruction for large lip defects. These flaps can often restore much of the function of the lip. However, they all lack in their ability to naturally restore lip aesthetics.
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        • Sakai S
        • Soekda S
        • Endo T
        • et al.
        A compound radial artery forearm flap for the reconstruction of lip and chin defect.
        Br J Plast Surg. 1989; 42: 337-338
        • Carroll CMA
        • Pathak I
        • Irish J
        • et al.
        Reconstruction of total lower lip and chin defects using the composite radial forearm – palmaris longus tendon free flap.
        Arch Facial Plast Surg. 2007; 2: 53-56
        • Jeng SF.
        Total lower lip reconstruction with a composite radial forearm- palmaris longus tendon flap: A clinical series.
        Plast Reconstr Surg. 2004; 113: 19-23
        • Sawhney CP.
        Reanimation of lower lip reconstructed by flaps.
        Br J Plast Surg. 1986; 39: 114
        • Jeng SF.
        Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip.
        Plast Reconstr Surg. 2004; 113: 491-498
        • Dewey EH
        • Roche AM
        • Lazarus CL
        • et al.
        Total lower lip and chin reconstruction with radial forearm free flap: A novel approach.
        Am J Otolaryngol. 2017; 38: 618-625
        • Daya M
        • Nair V
        Free radial forearm flap lip reconstruction: a clinical series and case reports of technical refinements.
        Ann Plast Surg. 2009; 62: 361-367
        • Yildirim S
        • Gideroğlu K
        • Aydogdu E
        • et al.
        Composite anterolateral thigh-fascia lata flap: A good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction.
        Plast Reconstr Surg. 2006; 117: 2033-2041
        • Lin YS
        • Liu WC
        • Lin YS
        • et al.
        Double-paddle peroneal flap for extensive lip defect reconstruction.
        Microsurgery. 2017; 37: 558-563
        • Özkan Ö
        • Özkan Ö
        • Çinpolat A
        • et al.
        Functional lower lip reconstruction with the partial latissimus dorsi muscle free flap without nerve coaptation.
        Microsurgery. 2019; 39: 131-137
        • Oh SJ
        • Chung CH.
        Upper-lip reconstruction using a free dorsalis pedis flap incorporating the extensor halluces and digitorum brevis muscles.
        Craniofac Surg. 2011; 22: 998-999
        • Chang KP
        • Lai CS
        • Tsai CC
        • et al.
        Total upper lip reconstruction with a free temporal scalp flap: Long-term follow-up.
        Head Neck. 2003; 25: 602-605
        • Bhama PK
        • Weinberg JS
        • Lindsay RW
        • et al.
        Objective outcomes analysis following microvascular gracilis transfer for facial reanimation: A review of 10 years’ experience.
        JAMA Facial Plast Surg. 2014; 16: 85-92
        • Lengele B
        • Testelin S
        • Bayet B
        • et al.
        Total lower lip functional reconstruction with a prefabricated gracilis muscle free flap.
        Int J Oral Maxillofac Surg. 2004; 33: 396
        • Cordova A
        • D'Arpa S
        • Moschella F
        Gracilis free muscle transfer for morpho-functional reconstruction of the lower lip.
        Head Neck. 2008; 30: 684
        • Cakmak MA
        • Cinal H
        • Barin EZ
        • et al.
        Total lower lip reconstruction with functional gracilis free muscle flap.
        J Craniofac Surg. 2018; 29: 735-737
        • Ninkovic M
        • Spanio di
        • Spilimbergo S
        • et al.
        Lower lip reconstruction: Introduction of a new procedure using a functioning gracilis muscle free flap.
        Reconstr Surg. 2007; 119: 1472-1480
        • Gundeslioglu AO
        • Karadag EC
        • Inan I
        • et al.
        Lip reconstruction using a functioning serratus anterior free flap: Preliminary study.
        Int J Oral Maxillofac Surg. 2017; 46: 1243-1247