title: Experiences with functional gracilis muscle flap in lower lip reconstruction.
abstract: OBJECTIVE
  Reconstruction of the lips is pivotal because the lips play an essential role in facial aesthetics and have unique functional properties. We presented our experience in reconstruction of total or subtotal lower lip defects with functional gracillis muscle flap covered split-thickness skin graft (STSG) in patients.
  
  
  METHODS
  Between 2009 and 2011, seven patients underwent resection of lower lip squamous cell carcinoma and lip reconstruction. Gracillis muscle flap was performed for reconstruction. Recipient vessels were the facial artery and vein. Motor nerve of the gracillis muscle was coapted to the marginal branch of the facial nerve. Gracillis muscle was covered with STSG. Patients were evaluated about mouth opening, oral competence, word articulation, the color match of the graft, the contraction of the muscle by physical examination. Electromyographic studies and sensation tests were performed.
  
  
  RESULTS
  Postoperative course was uneventful for all of the flaps. No microvascular revisions were needed. One patient was reoperated because of wound dehiscence under local anaesthesia. Mean follow up period was 15 months. After three months, movement of the reconstructed lip was observed. Color of the grafted skin was matched with the skin of the face. The patients had no problems with word articulation, oral continence, or mouth opening. The electromyographic study showed recovery of motor innervation. After 1 year, the patients demonstrated recovered sensitivity with the sensation test.
  
  
  CONCLUSIONS
  Considering functional results, superior aesthetic appearance, and minimal donor-site morbidity of the functional gracillis transfer covered skin graft, we think that this method may be an alternative for reconstruction of large full-thickness defects of the lower lip. © 2015 Wiley Periodicals, Inc. Microsurgery 37:487-493, 2017.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Osman Koray
authors.initials: OK
authors.lastname: Coskunfirat
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Gamze
authors.initials: G
authors.lastname: Bektas
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Ani
authors.initials: A
authors.lastname: Cinpolat
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Kerim
authors.initials: K
authors.lastname: Unal
authors.affiliation: Department of Anesthesiology, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: Nesil
authors.initials: N
authors.lastname: Coskunfirat
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D004576:Electromyography / Q000379:methods; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D000071976:Gracilis Muscle / Q000098:blood supply / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology