title: Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: a case report.
abstract: It is difficult to totally reconstruct the lips and achieve good functional and aesthetic results, such as oral sphincter function, sensation, appearance, color, and movement. There have been few reports of reconstructing complete lip defects. We present a case of completely reconstructing the lip defects of a 55-year-old patient who had verrucous carcinoma of the buccal mucosa and lips. Extensive ablation was performed by wide bilateral excision of the buccal mucosa and marginal resection of the anterior mandible and both lips. The tongue, partial tongue base mucosa, and retromolar trigone were preserved. To reconstruct and resurface the intraoral and lip defects nearly totally, we applied a free anterolateral thigh (ALT) flap in chimeric style with two independent sets of perforators and skin islands. To achieve better oral function and cosmetics, revisions of the ALT flap, full-thickness scrotal skin grafting, autologous fat grafting, and skin tattooing were done in stages. Postoperative oral sphincter function was obtained without drooling; the general appearance of the lips was also acceptable.
authors: Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
authors: Chien-Liang
authors: CL
authors: Lai
authors: Kuang-Wen
authors: KW
authors: Ou
authors: Wen-Kuan
authors: WK
authors: Chiu
authors: Shyi-Gen
authors: SG
authors: Chen
authors: Tim-Mo
authors: TM
authors: Chen
authors: Hsiao-Ping
authors: HP
authors: Li
authors: Shun-Cheng
authors: SC
authors: Chang
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002610:Cheek; D058752:Free Tissue Flaps / Q000098:blood supply; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology* / Q000601:surgery; D019647:Oral Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck