xRead - Facial Reconstruction Following Mohs Micrographic Surgery

Mohs Defects of the Lips and Chin

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Fig. 20. Karapandzic flap design. ( A ) Planned incision lines with excision of central lower lip defect. ( B ) The inci sion is placed through only skin and mucosa to preserve the musculature. ( C ) Closure of incision lines. ( From Ishii LE, Byrne PJ. Lip reconstruction. Facial Plast Surg Clin North Am 2009;17:451; with permission.)

Mucosa is advanced to restore the vermilion. A small triangle of skin and subcutaneous tissue from the commissuroplasty may be removed for a more nat ural result. However, caution must be taken to avoid oral incontinence. 3

Scar revision surgery is quite common and is often necessary to achieve the best results after lip recon structive surgery. Almost all perioral scars can be improved with dermabrasion. Long, vertical scars of the lip in the absence of other rhytids are quite

Fig. 21. Commissuroplasty design. ( A ) Small triangle of skin may be excised lateral to distorted commissure. ( B ) Horizontal incision placed through blunted commissure. ( C ) Mucosa advanced superiorly, inferiorly, and laterally to restore vermilion of lips and commissure. ( From Renner GJ. Reconstruction of the lip. In: Baker SR, editor. Local flaps in facial reconstruction. 2nd edition. St Louis (MO): Mosby; 2007. p. 513; with permission.)