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Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report

Authors

  • Chien-Liang Lai M.D.,

    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Kuang-Wen Ou M.D.,

    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Wen-Kuan Chiu M.D.,

    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Shyi-Gen Chen M.D.,

    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Tim-Mo Chen M.D.,

    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Hsiao-Ping Li M.D.,

    1. Division of Oral Surgery, Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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  • Shun-Cheng Chang M.D.

    Corresponding author
    1. Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
    • Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, #325, Section 2, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan, Republic of China
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Abstract

It is difficult to totally reconstruct the lips and achieve good functional and aesthetic results, such as oral sphincter function, sensation, appearance, color, and movement. There have been few reports of reconstructing complete lip defects. We present a case of completely reconstructing the lip defects of a 55-year-old patient who had verrucous carcinoma of the buccal mucosa and lips. Extensive ablation was performed by wide bilateral excision of the buccal mucosa and marginal resection of the anterior mandible and both lips. The tongue, partial tongue base mucosa, and retromolar trigone were preserved. To reconstruct and resurface the intraoral and lip defects nearly totally, we applied a free anterolateral thigh (ALT) flap in chimeric style with two independent sets of perforators and skin islands. To achieve better oral function and cosmetics, revisions of the ALT flap, full-thickness scrotal skin grafting, autologous fat grafting, and skin tattooing were done in stages. Postoperative oral sphincter function was obtained without drooling; the general appearance of the lips was also acceptable. © 2011 Wiley Periodicals, Inc. Microsurgery, 2012.

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