title: Repair of central upper lip (philtral) surgical defects with island pedicle flaps.
abstract: BACKGROUND
  Surgical defects of the central upper lip (philtrum) are a particularly difficult area to achieve satisfactory cosmetic and functional repair. Reconstruction of the central upper lip has been accomplished primarily through the use of side-to-side closure, bilateral advancement or rotation flap, and full-thickness graft. Repair may be complicated by distortion of the vermilion border, obliteration of the normal contour of the philtrum, eclabium, and trapdooring of the flap.
  
  
  OBJECTIVE
  We review the options for reconstruction of this area and describe our experience using an island pedicle flap to complete reconstruction.
  
  
  METHODS
  Four patients presented with basal cell carcinomas of the mid upper lip (philtrum). Tumors were cleared by Mohs micrographic surgery. Reconstruction was achieved by island pedicle flaps utilizing donor tissue from the superior philtrum.
  
  
  RESULTS
  The patients had excellent cosmetic results with minimal distortion of the vermilion border or obliteration of the philtrum or philtral ridges. Scars healed in a nearly imperceptible fashion, keeping within one cosmetic unit (the philtrum) without extending along the vermilion border as seen in bilateral advancement or rotation flaps.
  
  
  CONCLUSIONS
  Island pedicle flaps may be an effective cosmetic and functional repair of selected surgical defects of the central upper lip involving the philtrum.
authors.affiliation: Department of Dermatology, University of California, Los Angeles, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Kaufman
authors.forename: R C
authors.initials: RC
authors.lastname: Grekin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008046:Lip / Q000601:surgery*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*