The lips are necessary for oral competence, cosmesis, speech and feeding. Non melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas. Treatment is fairly simple when these are early lesions. With larger or recurrent lesions treatment is much more difficult. Occasionally the whole lower lip needs to be excised. Reconstruction is with local flaps such as the Bernard-Webster or a combination of other local flaps. The use of free flaps, mainly the radial forearm, with use of the palmaris longus tendon to support the flap (commissure to commissure) is well documented. In my experience these free flaps do not function well and local flaps used to reconstruct the lips in three layers function better. This is a case report of an elegant technique of a submental island flap to reconstruct the lower lip. There are excellent photographs and a small pertinent discussion. A review of a case report is unusual and indeed this is my first. It is however a very useful flap and the outcomes look very satisfactory.

The use of submental island flap for total lower lip reconstruction; a case report.
Guo Y, Mao C.
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Sunil K Bhatia

Royal Shrewsbury Hospital, Shrewsbury, UK.

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