Technical solution for reconstruction of upper lip defect by bilateral V-Y advanced flaps

A technical solution, "bilateral V-Y advanced flaps,"was used to repair the upper lip defect. The flaps work very well for patients with a depth of #5 mm defects covering one-third to one-half of the upper lip without involving the philtral ridge. One V-shaped flap was designed at the oral vestibule adjacent to the defect and another at the cutaneous side. The skin incision along the markings was made down to the subcutaneous tissue and the cutaneous flap was mobilized toward the adjacent mucocutaneous junction. Then, the mucosal flap was elevated onto the superficial layer of the orbicularis muscle, thereby creating a blood supply based on the vascular plexus formed by the small branches of the superior labial artery and the orbicularis muscle. To ensure refined vermiliocutaneous match, the inferior margins of the flaps were fixed with the base of the vermilion border using a 5-0 absorbable suture. Finally, we used a 6-0 suture to close the defect after trimming the excess skin around it (Fig 2). The flaps, which avoid microstomia and irregularity in vermilion, are highly recommended.