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

Chien-Liang Lai, Kuang-Wen Ou, Wen-Kuan Chiu, Shyi-Gen Chen, Tim-Mo Chen, Hsiao-Ping Li, Shun-Cheng Chang

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)60-63
Number of pages4
JournalMicrosurgery
Volume32
Issue number1
DOIs
Publication statusPublished - 2012
Externally publishedYes

Fingerprint

Lip
Thigh
Skin Transplantation
Mouth Mucosa
Tongue
Verrucous Carcinoma
Tattooing
Sialorrhea
Mandible
Esthetics
Cosmetics
Mucous Membrane
Color
Fats
Skin

Keywords

  • adult
  • anterolateral thigh flap
  • article
  • biopsy
  • cancer staging
  • case report
  • cheek mucosa
  • chimeric flap
  • follow up
  • full thickness skin graft
  • human
  • human tissue
  • hypersalivation
  • leukoplakia
  • lip reconstruction
  • lower lip
  • lymph node dissection
  • male
  • mandible
  • priority journal
  • skin island flap
  • surgical technique
  • tongue
  • tooth extraction
  • tumor ablation
  • upper lip
  • verrucous carcinoma
  • Carcinoma, Squamous Cell
  • Cheek
  • Free Tissue Flaps
  • Head and Neck Neoplasms
  • Humans
  • Lip
  • Lip Neoplasms
  • Male
  • Middle Aged
  • Mouth Mucosa
  • Oral Surgical Procedures
  • Reconstructive Surgical Procedures

Cite this

Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report. / Lai, Chien-Liang; Ou, Kuang-Wen; Chiu, Wen-Kuan; Chen, Shyi-Gen; Chen, Tim-Mo; Li, Hsiao-Ping; Chang, Shun-Cheng.

In: Microsurgery, Vol. 32, No. 1, 2012, p. 60-63.

Research output: Contribution to journalArticle

Lai, Chien-Liang ; Ou, Kuang-Wen ; Chiu, Wen-Kuan ; Chen, Shyi-Gen ; Chen, Tim-Mo ; Li, Hsiao-Ping ; Chang, Shun-Cheng. / Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report. In: Microsurgery. 2012 ; Vol. 32, No. 1. pp. 60-63.
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note = "被引用次數:8 Export Date: 21 March 2016 CODEN: MSRGD 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan; 電子郵件: dtdrummer@mail.ndmctsgh.edu.tw 參考文獻: Kang, C.-J., Chang, J.T.-C., Chen, T.-M., Chen, I.-H., Liao, C.-T., Surgical Treatment of Oral Verrucous Carcinoma (2003) Chang Gung Medical Journal, 26 (11), pp. 807-812; Kuo, Y.R., Jeng, S.F., Wei, F.C., Su, C.Y., Chien, C.Y., Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia (2008) Head Neck, 30, pp. 1001-1006; Karonidis, A., Yao, S.F., Chimeric anterolateral thigh free flap for head and neck reconstruction (2009) Plast Reconstr Aesthet Surg, 62, pp. e85-e86; Nthumba, P., Carter, L., Visor flap for total upper and lower lip reconstruction: A case report (2009) J Med Case Reports, 3, p. 7312; Keskin, M., Sutcu, M., Tosun, Z., Savaci, N., Reconstruction of total lower lip defects using radial forearm free flap with subsequent tongue flap (2010) J Craniofac Surg, 21, pp. 349-351; Jeng, S.F., Kuo, Y.R., Wei, F.C., Su, C.Y., Chien, C.Y., Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip (2004) Plast Reconstr Surg, 113, pp. 491-498; Daya, M., Simultaneous total upper and lower lip reconstruction with a free radial forearm-palmaris longus tendon and brachioradialis chimeric flap (2010) J Plast Reconstr Aesthet Surg, 63, pp. e75-e76; Ueda, K., Oba, S., Nakai, K., Okada, M., Kurokawa, N., Nuri, T., Functional reconstruction of the upper and lower lips and commissure with a forearm flap combined with a free gracilis muscle transfer (2009) J Plast Reconstr Aesthet Surg, 62, pp. e337-e340; Daya, M., Nair, V., Free radial forearm flap lip reconstruction: A clinical series and case reports of technical refinements (2009) Ann Plast Surg, 62, pp. 361-367; Wolford, L.M., Morales-Ryan, C.A., Morales, P.G., Cassano, D.S., Autologous fat grafts placed around temporomandibular joint total joint prostheses to prevent heterotopic bone formation (2008) Proc (Bayl Univ Med Cent), 21, pp. 248-254; Furuta, S., Hataya, Y., Watanabe, T., Yuzuriha, S., Vermilionplasty using medical tattooing after radial forearm flap reconstruction of the lower lip (1994) British Journal of Plastic Surgery, 47 (6), pp. 422-424; Yildirim, S., Gideroglu, K., Aydogdu, E., Avci, G., Akan, M., Akoz, T., Composite anterolateral thigh-fascia lata flap: A good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction (2006) Plastic and Reconstructive Surgery, 117 (6), pp. 2033-2041. , DOI 10.1097/01.prs.0000210663.59939.02, PII 0000653420060500000050; Sarukawa, S., Kashiwaya, G., Sakuraba, M., A new flap design for reconstruction of full-thickness defects of the lower lip: The extended upper lip island (EULI) flap (2006) Journal of Plastic, Reconstructive and Aesthetic Surgery, 59 (12), pp. 1436-1441. , DOI 10.1016/j.bjps.2005.12.043, PII S1748681506002671; Suda, T., Yotsuyanagi, T., Ezoe, K., Saito, T., Ikeda, K., Yamauchi, M., Arai, K., Reconstruction of a red lip that has a defect in one half, using the remaining red lip (2009) J Plast Reconstr Aesthet Surg, 62, pp. e570-e573. , Epub 2009 Jan 1; Yano, K., Hosokawa, K., Kubo, T., Combined tongue flap and V-Y advancement flap for lower lip defects (2005) British Journal of Plastic Surgery, 58 (2), pp. 258-262. , DOI 10.1016/j.bjps.2004.10.021, PII S0007122604003169; Wei, F.-C., Jain, V., Celik, N., Chen, H.-C., Chuang, D.C.-C., Lin, C.-H., Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps (2002) Plastic and Reconstructive Surgery, 109 (7), pp. 2219-2226",
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TY - JOUR

T1 - Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report

AU - Lai, Chien-Liang

AU - Ou, Kuang-Wen

AU - Chiu, Wen-Kuan

AU - Chen, Shyi-Gen

AU - Chen, Tim-Mo

AU - Li, Hsiao-Ping

AU - Chang, Shun-Cheng

N1 - 被引用次數:8 Export Date: 21 March 2016 CODEN: MSRGD 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, Cheng-Kung Road, Neihu, 114, Taipei, Taiwan; 電子郵件: dtdrummer@mail.ndmctsgh.edu.tw 參考文獻: Kang, C.-J., Chang, J.T.-C., Chen, T.-M., Chen, I.-H., Liao, C.-T., Surgical Treatment of Oral Verrucous Carcinoma (2003) Chang Gung Medical Journal, 26 (11), pp. 807-812; Kuo, Y.R., Jeng, S.F., Wei, F.C., Su, C.Y., Chien, C.Y., Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia (2008) Head Neck, 30, pp. 1001-1006; Karonidis, A., Yao, S.F., Chimeric anterolateral thigh free flap for head and neck reconstruction (2009) Plast Reconstr Aesthet Surg, 62, pp. e85-e86; Nthumba, P., Carter, L., Visor flap for total upper and lower lip reconstruction: A case report (2009) J Med Case Reports, 3, p. 7312; Keskin, M., Sutcu, M., Tosun, Z., Savaci, N., Reconstruction of total lower lip defects using radial forearm free flap with subsequent tongue flap (2010) J Craniofac Surg, 21, pp. 349-351; Jeng, S.F., Kuo, Y.R., Wei, F.C., Su, C.Y., Chien, C.Y., Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip (2004) Plast Reconstr Surg, 113, pp. 491-498; Daya, M., Simultaneous total upper and lower lip reconstruction with a free radial forearm-palmaris longus tendon and brachioradialis chimeric flap (2010) J Plast Reconstr Aesthet Surg, 63, pp. e75-e76; Ueda, K., Oba, S., Nakai, K., Okada, M., Kurokawa, N., Nuri, T., Functional reconstruction of the upper and lower lips and commissure with a forearm flap combined with a free gracilis muscle transfer (2009) J Plast Reconstr Aesthet Surg, 62, pp. e337-e340; Daya, M., Nair, V., Free radial forearm flap lip reconstruction: A clinical series and case reports of technical refinements (2009) Ann Plast Surg, 62, pp. 361-367; Wolford, L.M., Morales-Ryan, C.A., Morales, P.G., Cassano, D.S., Autologous fat grafts placed around temporomandibular joint total joint prostheses to prevent heterotopic bone formation (2008) Proc (Bayl Univ Med Cent), 21, pp. 248-254; Furuta, S., Hataya, Y., Watanabe, T., Yuzuriha, S., Vermilionplasty using medical tattooing after radial forearm flap reconstruction of the lower lip (1994) British Journal of Plastic Surgery, 47 (6), pp. 422-424; Yildirim, S., Gideroglu, K., Aydogdu, E., Avci, G., Akan, M., Akoz, T., Composite anterolateral thigh-fascia lata flap: A good alternative to radial forearm-palmaris longus flap for total lower lip reconstruction (2006) Plastic and Reconstructive Surgery, 117 (6), pp. 2033-2041. , DOI 10.1097/01.prs.0000210663.59939.02, PII 0000653420060500000050; Sarukawa, S., Kashiwaya, G., Sakuraba, M., A new flap design for reconstruction of full-thickness defects of the lower lip: The extended upper lip island (EULI) flap (2006) Journal of Plastic, Reconstructive and Aesthetic Surgery, 59 (12), pp. 1436-1441. , DOI 10.1016/j.bjps.2005.12.043, PII S1748681506002671; Suda, T., Yotsuyanagi, T., Ezoe, K., Saito, T., Ikeda, K., Yamauchi, M., Arai, K., Reconstruction of a red lip that has a defect in one half, using the remaining red lip (2009) J Plast Reconstr Aesthet Surg, 62, pp. e570-e573. , Epub 2009 Jan 1; Yano, K., Hosokawa, K., Kubo, T., Combined tongue flap and V-Y advancement flap for lower lip defects (2005) British Journal of Plastic Surgery, 58 (2), pp. 258-262. , DOI 10.1016/j.bjps.2004.10.021, PII S0007122604003169; Wei, F.-C., Jain, V., Celik, N., Chen, H.-C., Chuang, D.C.-C., Lin, C.-H., Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps (2002) Plastic and Reconstructive Surgery, 109 (7), pp. 2219-2226

PY - 2012

Y1 - 2012

N2 - 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.

AB - 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.

KW - adult

KW - anterolateral thigh flap

KW - article

KW - biopsy

KW - cancer staging

KW - case report

KW - cheek mucosa

KW - chimeric flap

KW - follow up

KW - full thickness skin graft

KW - human

KW - human tissue

KW - hypersalivation

KW - leukoplakia

KW - lip reconstruction

KW - lower lip

KW - lymph node dissection

KW - male

KW - mandible

KW - priority journal

KW - skin island flap

KW - surgical technique

KW - tongue

KW - tooth extraction

KW - tumor ablation

KW - upper lip

KW - verrucous carcinoma

KW - Carcinoma, Squamous Cell

KW - Cheek

KW - Free Tissue Flaps

KW - Head and Neck Neoplasms

KW - Humans

KW - Lip

KW - Lip Neoplasms

KW - Male

KW - Middle Aged

KW - Mouth Mucosa

KW - Oral Surgical Procedures

KW - Reconstructive Surgical Procedures

U2 - 10.1002/micr.20943

DO - 10.1002/micr.20943

M3 - Article

VL - 32

SP - 60

EP - 63

JO - Microsurgery

JF - Microsurgery

SN - 0738-1085

IS - 1

ER -