Evolving Modalities in Lower Lip Reconstruction Over the Past Quarter Century: -A Comparative Case Report

The landscape of reconstructive surgery has transformed dramatically in the 21st century. Advances in digital technology, surgical instrumentation, perioperative care, and microvascular techniques have expanded the boundaries of what is surgically possible. Procedures once considered unfeasible-particularly complex or tertiary reconstructions-are now routinely performed with predictable outcomes. Oncosurgical management has also evolved. Today, even extensive T4+ lesions and recurrent malignancies are excised and reconstructed using microvascular free flaps, enabling single-stage reconstruction. In contrast, during the early part of the century, most lower lip defects were managed with multistage pedicled flaps, often requiring prolonged treatment timelines. Modern free flap reconstruction allows earlier initiation of adjuvant radiotherapy and faster functional and social rehabilitation.