Burows Method of Reconstructing the Lateral Upper Lip 1855

Following the wedge excision of a tumor of the lateral upper lip (Fig. 6.48a), that part of the lip and the commissure can be reconstructed by a simple advancement technique following the excision of a Burow's triangle next to the lower lip. A mucosal flap raised adjacent to the lower lip (Fig. 6.48a, S) is used to resurface the de-epithelialized area (D) on the reconstruction flap. This restores an acceptable length to the oral fissure and yields a good cosmetic result (Fig. 6.48b; Zisser 1970). Brusati (1979) proposed a similar reconstruction for both commissures (Fig. 6.49).

Burow Triangle

Fig. 6.49 Reconstruction of the commissure by the method of Brusati (1979).

a The commissure is resected. Two Burow's triangles are excised from the cheek, and the cheek U-flap is advanced medially. A small area of the flap at the commissure is de-epithelialized (D). b The lip mucosa is mobilized and advanced (S) into the de-epithelialized area (D).

Fig. 6.49 Reconstruction of the commissure by the method of Brusati (1979).

a The commissure is resected. Two Burow's triangles are excised from the cheek, and the cheek U-flap is advanced medially. A small area of the flap at the commissure is de-epithelialized (D). b The lip mucosa is mobilized and advanced (S) into the de-epithelialized area (D).

Fig. 6.50a, b Reconstruction of the commissure by the method of Fries (1973) and Brusati (1979). If intraoral mucosa is not available, the vermilion can be mobilized and advanced (see Fig. 6.55).

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