Lip Reconstruction
Your lips are one of the most expressive parts of you face. Happiness, sorrow and every emotion in between are conveyed through this intricate structure. More importantly, fully functional lips are a prerequisite for normal speech and swallowing. Patients with abnormalities or deficits in their lips gain invaluable improvement with expertly performed lip reconstruction or other type of lip procedures.
Lip Conditions Requiring Reconstruction
Many conditions can result in the need for lip repair: congenital malformations, trauma, facial nerve paralysis or removal of cancerous lesions. Children born with congenital abnormalities such as a cleft lip need surgical repair within the first few months of life. Secondary cosmetic improvements of the lip can be performed when the child is older. Individuals with trauma to their lips, such as lacerations or dog bites, must be treated expeditiously. In patients with cancer involvement of the lip, reconstruction needs to be an integral part of overall treatment management.
Facial paralysis interferes with speech, swallowing, and the ability to manage oral secretions. These fictional losses exacerbate the psychological impact of facial paralysis. In patients with cancer involvement of the lip, reconstruction needs to be an integral part of over all management.
Dr. Khosh is expert in addressing lip deformities due to any cause. He will take time to explain various options, which may be available for repair of a lip deformity. He has unmatched experience in tissue transfer techniques to restore lip function. In more minor defects, Dr. Khosh uses simpler techniques to restore the aesthetic appearance of the lip.
Contact us today to schedule a consultation with Dr. Khosh for you or a member of your family.
Case Studies
Missing upper middle lip
This 65 year-old-man had cancer removal from the upper middle lip with a full thickness defect of the lip. The lip cancer was removed with the Mohs technique. In repairing the defect, Dr. Khosh advanced the lip edges and hid the scar imperceptibly, to restore the function and aesthetics of the lip.
- Patient: 65 year-old-man with lip cancer
- Problem: Missing upper middle lip
- Procedure: Bilateral advancement flaps
Missing 70% of lower lip
This 71 year-old-woman had cancer involvement of the majority of the lower lip. Dr. Khosh used the two-staged Abbe-Estelander flap (lip switch flap) to move some tissue form the upper lip to the lower lip. The scar in the lips is well hidden, and lip function was restored.
- Patient: 71 year-old-woman with lip cancer
- Problem: Missing majority of lower lip
- Procedure: 2 staged Abbe-Estlander flap (lip switch flap)
Missing lower lip lining
This 69 year-old-man had basal cell cancer of lower lip. The cancer was removed with Mohs technique. The red part of the lip was missing with intact underlying muscle. Dr. Khosh used a mucosa flap (the lining of the mouth) from inside the mouth to provide a good match to the normally red part of the lip.
- Patient: 69 year-old-man with lip cancer
- Problem: Missing lower lip with intact underlying muscle
- Procedure: Mucosal flap (transfer of the lining of the mouth)
Missing 1/3 of lower lip
This 45 year-old-man had basal cell cancer of lower lip. Cancer was removed with Mohs technique. Dr. Khosh advanced the intact edges of the lip to restore normal lip function. The length of the scar was limited by using a technique known as “M-plasty”.
- Patient: 45 year-old-man with lower lip cancer
- Problem: Missing muscle and lining of the lower lip
- Procedure: Advancement flap and M-plasty
Missing entire lower lip
This 52 year-old-man had squamous cell cancer of the lower lip. During Mohs surgery for cancer removal, nearly all the lower lip was removed. Dr. Khosh used a special surgical technique, known as a Karapandzic flap, to mobilized tissue around the mouth allowing closure of the lip. The post op picture was taken one week after surgery.
- Patient: 52 year-old-man with lip cancer
- Problem: Missing entire lower lip
- Procedure: Karapandzic flap
Small defect of upper lip near nose
This 51 year-old-woman had a basal cell cancer of upper lip near the nose. Mohs surgery resulted in an 8-mm circular defect near the nose. Dr. Khosh repaired this with local tissue advancement to hide the scar at the junction of the lip and the nose.
- Patient: 51 year-old-woman with cancer of the lip
- Problem: 8-mm defect near the nose
- Procedure: Local tissue advancement
Disclaimer: These are actual results for patients of Dr. Maurice Khosh. Plastic and cosmetic surgery results can vary between patients.
Frequently Asked Questions
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This is dependent on the nature of reconstruction. Small procedures for lip reconstruction such as local flaps and direct closure can be performed as an office procedure under local anesthesia. More complicated procedures involving large lip defects commonly require sedation or general anesthesia in an operating room.
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Whistle lip deformity is a central notching of the upper lip following repair of a cleft lip, or following repair of a central upper lip defect. It is due to missing soft tissue. Repair can be accomplished with small local flaps, or with injection of filler agents such as Restylane or Juvederm.
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The Abbe Estelander flap is a lip switch technique in which a defect of the upper lip is repaired with tissue borrowed from the lower lip, and vice versa. It is ideal for lip defects that involve more than half of the lip. The Abbe Estelander flap is performed in two stages that are separated by two or more weeks.
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When a lip defect involves more that 75% of the lip, the Karapandnzic flap can be used for repair. Circular flaps from around the mouth are used to repair the defect. The Karapandnzic flap preserves the nerve and vascular supply of the residual lip, and allows immediate lip function.
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The Karapandnzic flap can be used for lip repair when the defect is greater than 75% of the lip. Circular flaps from around the mouth are used to repair the defect. The Karapandnzic flap preserves the nerve and vascular supply of the residual lip, and allows immediate lip function.
Related Procedures
Lip reconstruction for traumatic, congenital, or cancer removal aims at restoring the function and appearance of the lips. The procedures are typically not associated with other facial treatments. Occasionally, laser treatments are used to help camouflage skin scars.
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