The authors present a well-structured review of the reconstruction of cutaneous defects of the cheek and lip. They present new findings that have an impact on the planning and understanding of local flaps for the reconstruction of both areas. Integrated soft-tissue anatomy includes retaining ligaments and their differences in the medial and lateral segments of the cheek. Recent research includes unique surface anatomy relationships of the ageing cheek, which offer further areas for scar camouflage in addition to conventional relaxed skin tension lines or borders of aesthetic subunits. In order to understand various flap principles, the authors present up-to-date findings of vascular anatomy. In the section about the cheek reconstruction, advantages and drawbacks of various concepts are discussed in relationship to defect size and patients’ expectations. The presented methods include healing by secondary intention, cervicofacial advancement rotation flap, V-Y subcutaneous tissue pedicled island advancement flap. For lip reconstruction the authors divide defects between those isolated to the vermillion and cutaneous defects of the upper and lower lip. Of special interest are their indications for conversion of partial-thickness defects to full-thickness defects followed by primary closure. In conclusion, this compact review offers detailed knowledge of up-to-date soft tissue anatomy of the cheek and lip with several techniques of local flap reconstruction for both areas of interest.

Local flaps: cheek and lip reconstruction.
Pepper J-P, Baker SR.
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Gregor M Bran

Dr Horst Schmidt Kliniken, Wiesbaden, Germany.

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