Repair of midline vertical lower lip deficiency after mandible reconstruction

Background When lower lip incisions are combined with anterior oromandibular resection and composite flap reconstruction, increased potential exists for abnormal healing of the lower lip. The aim of this study is to describe these deformities and operative techniques for their correction. Methods A retrospective review of all patients undergoing oromandibular reconstruction with osteocutaneous free tissue transfer at Indiana University Medical Center and Affiliated Hospitals during the 5-year period between January 1991 and 1996 was performed. Patients requiring secondary lower lip revision or repair were identified. Patient characteristics, lip deformities, and operative correction techniques were detailed. Results Sixty patients underwent 62 free tissue transfers for oromandibular reconstructions. Five patients (7.1%) required reoperation for lower lip deformities related to abnormal wound healing. All affected patients had lower lip split incisions for access to the oropharynx and composite anterior floor of mouth and mandibular resection and reconstruction. Each patient had successful repair of the lower lip deformity and correction of related functional deficits using lower lip tissue. Conclusion Lower lip deformities occur in a subset of patients undergoing anterior mandibular reconstruction. Horizontally redundant lower lip tissue can be mobilized to repair the secondary aesthetic and functional deficits.