title: Combined submental flap with toe web for reconstruction of the lip with oral commissure.
abstract: We present a new method employing a combined submental island flap and dorsalis pedis flap with the first toe web for reconstruction of a large lip defect including the oral commissure. The advantages of this method are: there is an excellent colour match; an anatomical structure similar to that of the oral commissure produces excellent results; there is superb function of the oral commissure; a donor-scar deformity can be avoided, since both flaps come from concealed areas; and good lining by the thin dorsal skin of the foot and submental skin results in a single-stage operation. The disadvantages are that complicated microvascular anastomoses may be required and there is a possibility of venous congestion of the submental flap in cases with a hypoplastic venous system. The use of the anterior jugular vein within the flap may be a key to overcoming this problem.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Okayama University Medical School, Okayama City, Okayama, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Koshima
authors.forename: K
authors.initials: K
authors.lastname: Inagawa
authors.forename: K
authors.initials: K
authors.lastname: Urushibara
authors.forename: T
authors.initials: T
authors.lastname: Moriguchi
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply