Reconstruction of the Lower Lip and Chin with the Composite Radial Forearm—Palmaris Longus Free Flap

Four cases of total lip and chin reconstruction are presented. In three, the composite radial forearm-palmaris longus free flap was used for reconstruction. In the fourth case, the palmaris longus was separated from the flap but still used as a lower lip sling. In all cases, the entire lower lip and the soft tissue of the chin were reconstructed in one stage. All patients healed primarily, and the three who underwent radiotherapy tolerated it without complications. Lip seal and speech were good, and there was no problem with drooling. Postoperative results emphasize the importance of respecting the aesthetic unit of the lower lip and chin. it involved his entire lower lip and a portion of the chin. In addition, the patient had experienced drooling and difficulty eating or holding cigarettes in his mouth. Physical examination revealed a large ulcerative mass involving the entire lower lip and a hard mass in the submandibular region. The patient was taken to surgery, where a total lower lip and chin resection was performed from commissure to commissure. In addition, a neck dissection was performed. The patient was reconstructed with a left radial artery fasciocutaneous flap with a palmaris longus tendon graft in continuity for lower lip reconstruction. The patient is doing well after 2 years of follow-up.