Abstract
Total lower lip defects often require free flaps for reconstruction to achieve optimal outcome.
Here we present a case of a young woman who developed a severe mucormycosis of the lower lip during immunosuppression due to hemophagocytic syndrome. After debridement, the resulting defect included the whole lower lip and skin of the labiomental sulcus, in addition to part of the right upper lip eventually leading to drooling, altered speech, and a cosmetically severed lower face. Reconstruction was performed with a composite sensate free radial forearm flap for inner lining and skin coverage, including the palmaris longus tendon for suspension and lateral antebrachial cutaneous nerve coapted to the left mental nerve for sensation. The right upper lip vermilion was addressed using an advancement flap. After an uneventful postoperative course, secondary procedures included sculpture of the flap, scar correction, and tattooing for vermilion reconstruction achieving an excellent functional and cosmetic outcome by restoring lip sensation, appearance, and oral continence.
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Schweizer, R., Rodriguez-Lorenzo, A. (2022). Total Lower Lip Reconstruction with Innervated Radial Forearm Flap and Palmaris Longus Tendon. In: Gravvanis, A., Kakagia, D.D., Ramakrishnan, V. (eds) Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-23706-6_15
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DOI: https://doi.org/10.1007/978-3-030-23706-6_15
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