Abbe Flap 1898

Moderate-sized defects of the upper lip can be repaired by transposing a wedge-shaped flap from the lower lip based on the inferior labial artery. The Abbe

Fig. 6.19 Modified cheek advancement of Weerda et al. (1981, 1990).

a The flap is cut and the cheek is mobilized, aided by a crescent-shaped excision in the area of the alar groove and lateral nose. b The completed repair.

Wedge Excision Lip Upper Lip Reconstruction South Florida

Fig. 6.20 Upper lip reconstruction by the method of Celsus (ca. 25 A.D.) and Bruns (1859).

a A two-layer, crescent-shaped excision is made lateral to the alar groove, and the incision is extended along the nasal base. (For larger defects, the mucosa is mobilized.) b The completed repair.

Abbe Flap Surgery

Fig. 6.21 Upper lip reconstruction by the method of Celsus (ca. 25 A.D.) and Abbe flap (1898). a Mobilization of the upper lip (see Fig 6.20) and three-layered incision of the Abbe flap (see Fig 6.22). b The Abbe flap is rotated into the upper lip defect.

c About 20 days later the pedicle is divided and the small lip defects are closed.

Fig. 6.21 Upper lip reconstruction by the method of Celsus (ca. 25 A.D.) and Abbe flap (1898). a Mobilization of the upper lip (see Fig 6.20) and three-layered incision of the Abbe flap (see Fig 6.22). b The Abbe flap is rotated into the upper lip defect.

c About 20 days later the pedicle is divided and the small lip defects are closed.

Pedicle Flap

Fig. 6.22a, b Three-layered Abbe flap (1898) from the lower lip (see also Figs. 6.23 and 6.24). a Incision of the three-layered

Abbe flap in the lower lip. b Rotation of the Abbe flap into the upper lip defect. The flap is divided about 20 days later

Fig. 6.22a, b Three-layered Abbe flap (1898) from the lower lip (see also Figs. 6.23 and 6.24). a Incision of the three-layered

Abbe flap in the lower lip. b Rotation of the Abbe flap into the upper lip defect. The flap is divided about 20 days later

Abbe Flap Inset
Fig. 6.23 Modification of the Abbé flap (Converse 1977; see Figs. 6.22 and 6.24).

„lip switch" is particularly useful for reconstructing defects associated with a cleft lip or the excision of a medially located tumor (Fig. 6.22a, b). About 16-20 days after the flap has been inset, its vascular pedicle is divided (see Fig. 6.21b, c). A prong-shaped flap can also be designed (Fig. 6.23; Converse 1977). A Z-plasty can be added to disperse the scar in the lower lip area (see Fig. 6.24d, e).

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