title: Gracilis free muscle transfer for morpho-functional reconstruction of the lower lip.
abstract: BACKGROUND
  Large full-thickness defects of the lower lip need free tissue transfer. The free forearm flap is the more widespread technique for free flap lower lip reconstruction, but it results in a static lip. The authors describe a technique of morphodynamic sensate reconstruction of the lower lip with a free gracilis flap and a musculomucosal flap.
  
  
  METHODS
  Three patients underwent reconstruction with an innervated free muscular gracilis flap, an innervated musculo-mucosal flap for the vermillion (2 cases), and a full-thickness skin graft.
  
  
  RESULTS
  No significant complications were observed. Static function and vermillion sensitivity were immediately restored. The skin color match was excellent. After 9 months, contraction of the transferred muscle was evident.
  
  
  CONCLUSIONS
  The lip is a dynamic unit. The innervated gracilis muscle seems ideal for lip reconstruction in that it correctly replaces all the lip layers and compensates for the lost function much better than a static technique.
authors.affiliation: Cattedra di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline Chirurgiche ed Oncologiche, Università degli Studi di Palermo, Palermo, Italy. adriana.cordova@excite.com
authors.forename: Adriana
authors.initials: A
authors.lastname: Cordova
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Arpa
authors.forename: Francesco
authors.initials: F
authors.lastname: Moschella
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D013524:Surgical Flaps