title: Submandibular artery: bilobed platysma myocutaneous flap for total lower lip reconstruction.
abstract: BACKGROUND
  Lower lip reconstruction following cancer resection includes a variety of clinical and microsurgical options.
  
  
  OBJECTIVE
  We have developed a myocutaneous flap for full thickness reconstruction with a functioning muscle.
  
  
  METHODS
  In all patients, the submandibular artery was outlined using computerized tomographic angiography and Doppler. The flap was designed after resection. The first lobe was designed to fill the defect and was outlined 90° from the defect margin, with the submandibular artery in the center of the flap. A second lobe was then outlined 90° from the first lobe. The flap was raised along with the platysma muscle and artery, with the first lobe rotated to the lip and the second lobe inset into the first lobe site, permitting neck closure without skin redundancy.
  
  
  RESULTS
  From January to May 2012, 17 patients were treated with this flap, and all flaps survived. All of the patients had oral continence at sixteen months, and electromyography documented platysma function.
  
  
  CONCLUSIONS
  The flap provides single-stage lower lip reconstruction with functional muscle.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Ege University, Izmir, Turkey. Electronic address: ovuncakdemir@gmail.com.
authors.forename: Ovunc
authors.initials: O
authors.lastname: Akdemir
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Central Mississippi Medical Center, Jackson, MS, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Lineaweaver
authors.affiliation: Department of Anatomy, Ege University, Izmir, Turkey.
authors.forename: Servet
authors.initials: S
authors.lastname: Celik
authors.affiliation: Department of Radiology, Ege University, Izmir, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Cınar
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, University of Mississippi, Jackson, MS, USA.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004435:Eating / Q000502:physiology; D004576:Electromyography / Q000379:methods; D005152:Facial Muscles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery; D008297:Male; D008334:Mandible / Q000098:blood supply*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation*; D061646:Operative Time; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures / Q000379:methods*; D000069259:Superficial Musculoaponeurotic System / Q000098:blood supply / Q000637:transplantation*; D014057:Tomography, X-Ray Computed / Q000379:methods; D018608:Ultrasonography, Doppler / Q000379:methods
keywords: Bilobed; Flap; Lip; Myocutaneous; Reconstruction; Submandibular artery