title: Functional lower lip reconstruction with the modified Bernard-Webster flap.
abstract: BACKGROUND
  Lower lip defects after squamous cell carcinoma (SCC) excisions have been repaired by several surgical techniques. However, the functional reconstruction of full-thickness defects of the lower lip remains a therapeutic challenge. We therefore evaluated functional results of the modified Bernard-Webster flap for the reconstruction of full-thickness lower lip defects after SCC excisions.
  
  
  METHODS
  A prospective study was performed on all patients with lower lip full-thickness defects after SCC excisions greater than 1/3 of the lip, reconstructed with the modified Bernard-Webster flap in 2011-2013. Functional (sphincter, motor, and sensory functions) postoperative results were evaluated according to criteria previously adopted.
  
  
  RESULTS
  Twelve lower lip defects were reconstructed without complications, except for two (16.7%) wound dehiscence successfully managed. Ten (83.3%) patients presented transient and permanent functional abnormalities in the recent and late postoperative assessments. Ten (83.3%) patients classified the late functional results as satisfactory.
  
  
  CONCLUSIONS
  The modified Bernard-Webster flap proved to be an excellent alternative to repair full-thickness lower lip defects with more than 1/3 of the lower lip length, as it allowed the use of similar neighboring tissues, could be performed in one stage, and was functionally effective.
authors.affiliation: Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Denadai
authors.affiliation: Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
authors.forename: Cassio Eduardo
authors.initials: CE
authors.lastname: Raposo-Amaral
authors.affiliation: Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
authors.forename: Celso Luiz
authors.initials: CL
authors.lastname: Buzzo
authors.affiliation: Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil. Electronic address: cesaraugustoraposo@hotmail.com.
authors.forename: Cesar Augusto
authors.initials: CA
authors.lastname: Raposo-Amaral
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005149:Facial Expression; D005152:Facial Muscles / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008046:Lip / Q000503:physiopathology / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D015361:Rhytidoplasty / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome
keywords: Bernard–Webster flap; Functional reconstruction; Lower lip reconstruction; Modified flap