title: Two-Thirds Lip Defects: A New Combined Reconstructive Technique for Patients With Epithelial Cancer.
abstract: BACKGROUND
  The lips are a common site prone to squamous cell carcinomas, which arise in the facial region. There are different techniques to reconstruct the excised lip region, according to dimensions, area, and position of the tumor. The authors describe a new technique of lip reconstruction born from a combination between a nasolabial flap and adipose tissue transplant.
  
  
  METHODS
  The study was lead in the Plastic and Reconstructive Surgery Department of the University of Catanzaro. It includes 10 patients with squamous and basal cell carcinomas that interested lower or upper lip. The authors used a nasolabial flap to reconstruct two-thirds of the excised lip. All patients were staged and resulted free of disease. As a result of surgery, deformities and depressions persisted in 5 patients. This induced the authors to subject them to transplantation of adipose tissue to maximize results. Aesthetic and functional evaluation was performed with the Patient and Observer Scar Assessment Scale v 2.0 and drooling rating scale questionnaires. Moreover, an anthropometric analysis was performed in patients treated with fat transplant. Data were analyzed using Wilcoxon signed-rank test.
  
  
  RESULTS
  All patients had an acceptable aesthetic and functional outcome. Oral competence, sensation, and movements of the area were adequate and aesthetic was good. Adipose tissue transplant compared with surgery alone, determine a real modification of various parameters, that was statistically significant (P = 0.043) to our analysis.
  
  
  CONCLUSIONS
  The inverted nasolabial flap is versatile and simple. This technique allows to repair large lip defects by maintaining the eurythmia of the face. Autologous fat transplant is a favorable filler. Our data show that surgery alone is unable to restore face eurythmia after a tumor excision. Adipose tissue transplant allows to reach this goal. These 2 techniques, together, may significantly modify the functional and aesthetic result of the lip reconstruction, ensuring an optimal long-term result.
authors.affiliation: *Department of Experimental and Clinical Medicine, University "Magna Græcia" of Catanzaro, Catanzaro†Department of Surgery "P Valdoni," University of Rome La Sapienza, Rome, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Vitagliano
authors.forename: Lucia Stella
authors.initials: LS
authors.lastname: Curto
authors.forename: Antonio
authors.initials: A
authors.lastname: Greto Ciriaco
authors.forename: Pietro
authors.initials: P
authors.lastname: Gareri
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Manfredi
authors.initials: M
authors.lastname: Greco
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000328:Adult; D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D002921:Cicatrix / Q000601:surgery; D004955:Esthetics, Dental; D005145:Face / Q000601:surgery; D005260:Female; D006801:Humans; D008046:Lip / Q000601:surgery*; D008048:Lip Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery*