xRead - Facial Reconstruction Following Mohs Micrographic Surgery

Larrabee & Moyer

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V-Y

2. Ishii LE, Byrne PJ. Lip reconstruction. Facial Plast Surg Clin North Am 2009;17:445–53. 3. Renner GJ. Reconstruction of the lip. In: Baker SR, editor. Local flaps in facial reconstruction. 2nd edition. St Louis (MO): Mosby; 2007. p. 476–524. 4. Langstein HN, Robb GL. Lip and perioral recon struction. Clin Plast Surg 2005;32:431–45, viii. 5. Nakamura N, Kawano S, Nakao Y, et al. An alterna tive method for vermilion reconstruction after resec tion of hemangiomas of the lip. J Oral Maxillofac Surg 2005;63:1239–43. 6. Baker SR. Advancement flaps. In: Baker SR, editor. Local flaps in facial reconstruction. 2nd edition. St Louis (MO): Mosby; 2007. p. 157–87. 7. Skouge JW. Upper lip repair–the subcutaneous is land pedicle flap. J Dermatol Surg Oncol 1990;16: 63–8. 8. Walike JW, Larrabee WF Jr. The ’note flap’. Arch Oto laryngol 1985;111:430–3. 9. Baker SR. Transposition flaps. In: Baker SR, editor. Local flaps in facial reconstruction. 2nd edition. St Louis: Mosby; 2007. p. 133–56. 10. Larrabee WF Jr. Design of local skin flaps. Otolar yngol Clin North Am 1990;23:899–923. 11. Converse JM, Wood-Smith D. Techniques for repair of defects of the lips and cheeks. In: Converse JM, editor. Reconstructive plastic surgery. Philadelphia: W.B. Saunders Company; 1977. p. 1544–94. 12. Ridley MB, VanHook SM. Aesthetic facial propor tions. In: Papel ID, editor. Facial plastic and recon structive surgery. 3rd edition. New York: Thieme; 2009. p. 119–33.

V-Y flaps can be used for lateral chin defects. V-Y flaps for chin defects have the disadvantage of fewer natural creases in which to hide an incision. This disadvantage is in contrast to the V-Y flaps explained earlier for lip defects whereby one of the incisions can be placed in the melolabial crease ( Fig. 24 ). Reconstruction of defects of the lips after Mohs micrographic surgery needs to encompass both functional and aesthetic concerns. The lower lip and chin compose two-thirds of the lower portion of the face. Various flaps exist for repair of cutaneous defects after Mohs surgery. For small defects, elliptical excision with primary closure is a viable option. Lip repair should reconstruct the layers of the lip, including mu cosa, muscle, and the vermillion or cutaneous lip. It is especially important to realign the vermil lion border precisely for optimal results. Chin defect repair is made challenging by the thicker nature of the skin and tendency for depressed scarring. Reconstructions with local flaps can be improved on by scar revision for optimal results. SUMMARY

REFERENCES

1. Coppit GL, Lin DT, Burkey BB. Current concepts in lip reconstruction. Curr Opin Otolaryngol Head Neck Surg 2004;12:281–7.