Management
The technical note by Rahpeyma A and Khajehahmadi S [PMID:28328601] demonstrates the use of a cross lip vermilion flap from the lower lip to improve upper lip vermilion deficiency, emphasizing patient selection to avoid complications like color mismatch and lower lip thinning.
From January to May 2012, 17 patients underwent reconstruction using this flap technique, with all flaps surviving and maintaining oral continence at sixteen months [PMID:25209383].
Split grafts from the 'dry' vermilion have been successfully used as overgrafts in reconstructive lip surgery, replacing abnormal scar or 'wet' mucosa with 'dry' vermilion that integrates well at the mucocutaneous junction [PMID:7066590].
Complications
Rahpeyma A and Khajehahmadi S [PMID:28328601] highlight that careful patient selection is crucial to prevent complications such as color mismatch and thinning of the lower lip when using the cross lip vermilion flap technique.
The design of the second lobe allowed for insetting into the first lobe site, which helped in achieving neck closure without skin redundancy [PMID:25209383].
In a series of ten patients, no significant complications were reported following the application of split vermilion grafts for lip reconstruction [PMID:7066590].
Prognosis & Follow-up
According to Rahpeyma A and Khajehahmadi S [PMID:28328601], the cross lip vermilion flap not only addresses vermilion deficiency but also offers indirect benefits including reduced visibility of upper incisor teeth and better symmetry in lip thickness, which are important for long-term aesthetic outcomes.
Electromyography documented functional platysma muscle at sixteen months follow-up, indicating preserved muscle function [PMID:25209383].
The aesthetic benefit observed in patients receiving split vermilion grafts has been deemed sufficient to justify the surgical intervention [PMID:7066590].
References
1 Rahpeyma A, Khajehahmadi S. Improving the Results of Cross Lip Vermilion Flap in Cleft Patients. The Journal of craniofacial surgery 2017. link 2 Akdemir O, Lineaweaver WC, Celik S, Cınar C, Zhang F. Submandibular artery: bilobed platysma myocutaneous flap for total lower lip reconstruction. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery 2014. link 3 Vecchione TR. Split vermilion grafts in reconstructive lip surgery. British journal of plastic surgery 1982. link90088-1)