Large Superficial Defects

Vermilion defects involving up to one-third the length of the lip can be repaired with a sliding flap (Fig. 6.2a), or the entire myomucosal stump can be mobilized as an advancement flap as described by Goldstein (1990). The natural elasticity of the lip mucosa permits good coverage of the defect (Fig. 6.2b; see also Fig. 6.53). These techniques can also be combined with the methods described by Blasius (see Figs. 6.25 and 6.26).

Fig. 6.1 Wedge-shaped defect in the vermilion of the lower lip. a The defect is excised.

b Inferiorly and superiorly based mucosal triangles are cut in preparation for a Z-plasty. c The triangles are transposed, and the muscular wound is closed.

d The small skin defects are closed.

Fig. 6.2 Large superficial mucosal defect in the right lower lip (involving less than one-third of the lip). a The intact lip mucosa is mobilized and advanced to cover the defect.

b The flap is sutured in place (see Fig. 6.54).

Fig. 6.2 Large superficial mucosal defect in the right lower lip (involving less than one-third of the lip). a The intact lip mucosa is mobilized and advanced to cover the defect.

b The flap is sutured in place (see Fig. 6.54).

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