Thin Upper Lip and Full Lower

A bipedicle flap can be used to add substance to the upper lip in a patient with a full lower lip, and viceversa (Fig. 6.7a, b). The pedicle is divided about 3 weeks after the initial transfer.

Full Lower Lip

Fig. 6.3 V-Y advancement for adding median fullness to a thin upper lip.

Fig. 6.4 Widening the upper lip on one side.

a The lip height is measured on the opposite side and drawn on the affected side. A strip of skin is excised, and the vermilion is slightly mobilized. b The incision is closed (with 6-0 or 7-0 monofilament) to create a new vermilion border. This type of operation can be used for total advancement of the upper lip area.

Fig. 6.4 Widening the upper lip on one side.

a The lip height is measured on the opposite side and drawn on the affected side. A strip of skin is excised, and the vermilion is slightly mobilized. b The incision is closed (with 6-0 or 7-0 monofilament) to create a new vermilion border. This type of operation can be used for total advancement of the upper lip area.

Fig. 6.3 V-Y advancement for adding median fullness to a thin upper lip.

Fig. 6.5 V-Y advancement for adding upper lip fullness and improving the shape of the cupid's bow. a The flap incisions are made, skirting the cupid's bow. b The V-Y advancement is completed.

Fig. 6.6 W-plasty for adding substance to the mid-upper lip. a The W-shaped incision is made around the vestibular mucosa and is carried laterally into the upper lip. b The small flaps are transposed to close the defects.

Fig. 6.5 V-Y advancement for adding upper lip fullness and improving the shape of the cupid's bow. a The flap incisions are made, skirting the cupid's bow. b The V-Y advancement is completed.

Fig. 6.6 W-plasty for adding substance to the mid-upper lip. a The W-shaped incision is made around the vestibular mucosa and is carried laterally into the upper lip. b The small flaps are transposed to close the defects.

Spare Upper Lip And Full Lower Lip

Fig. 6.7 Augmenting the upper lip from a full lower lip. a A bipedicle flap is cut from the lower lip, and the upper lip is incised.

b The bipedicle flap (mucosa or myomucosa) is transferred to the upper lip. The donor defect is closed (the flap base is divided and inset 3 weeks later).

Fig. 6.7 Augmenting the upper lip from a full lower lip. a A bipedicle flap is cut from the lower lip, and the upper lip is incised.

b The bipedicle flap (mucosa or myomucosa) is transferred to the upper lip. The donor defect is closed (the flap base is divided and inset 3 weeks later).

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