title: Total lower lip reconstruction with innervated muscle-bearing flaps: a modification of the Webster flap.
abstract: BACKGROUND
  Mohs surgery and other surgical techniques are used for the removal of squamous cell carcinoma of the lower lip and may leave a large defect in the vermilion and underlying tissue. When nearly the entire lower lip is excised, reconstruction of this defect is a challenge. Repair requires the matching of vermilion color, maintenance of oral sphincter function and mouth opening size, and retention of sensation. Several techniques have been suggested. We present a modification of the Webster flap for total lower lip reconstruction using innervated muscle-bearing flaps.
  
  
  OBJECTIVE
  To present a surgical technique for the reconstruction of total lower lip defects after excision of squamous cell carcinoma.
  
  
  METHODS
  Innervated muscle-bearing flaps are used and demonstrated in one case. The surgical technique is discussed in detail.
  
  
  RESULTS
  The reconstructive results were excellent. There were no postoperative complications.
  
  
  CONCLUSIONS
  The use of innervated muscle-bearing flaps is a useful and effective option for the reconstruction of total lower lip defects.
authors.affiliation: Mohs Surgical Unit and Department of Plastic and Reconstructive Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel. zilinsky@netvision.net.il
authors.forename: I
authors.initials: I
authors.lastname: Zilinsky
authors.forename: E
authors.initials: E
authors.lastname: Winkler
authors.forename: G
authors.initials: G
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Haik
authors.forename: J
authors.initials: J
authors.lastname: Tamir
authors.forename: A
authors.initials: A
authors.lastname: Orenstein
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D015580:Mohs Surgery / Q000534:rehabilitation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000294:innervation