Bilateral superior labial artery embolization for arteriovenous malformation

Lip arteriovenous malformations (AVMs) are typically present at birth and can lead to progressive tissue destruction and functional and cosmetic issues. Their management is challenging due to the lack of standardized protocols and may involve both surgical and non-surgical approaches. The authors present a case of upper lip AVM with feeders bilaterally from both facial arteries and their superior labial branch arteries. Bilateral Gelfoam embolization of the labial arteries followed by surgical resection was performed. The upper lip was reconstructed using a bilateral advancement flap. The patient's intraoperative and postoperative courses were uneventful, and no recurrence was recorded. The functional and aesthetic results were good and satisfying for the patient at the 1-year follow up. Upper lip AVMs can be managed through a combination of presurgical embolization and complete surgical resection. The use of a rapidly absorbable embolic material does not compromise the surgical resection procedure and reduces the risk of complications such as necrosis of the upper lip, especially in cases where it is necessary to embolize both upper labial arteries.