Functional and Aesthetic Reconstruction of Full-Thickness Defects of the Lower Lip After Tumor Resection: Analysis of 59 Cases and Discussion of a Surgical Approach

BACKGROUND: Carcinoma of the lower lip is a common cancer of the head and neck region. The accepted standard of care is surgical resection and reconstruction. The delicate location poses a challenge to surgeons because they have to aim for conflicting goals: complete oncological resection and functional and aesthetic restoration. For over a century, this challenge led to the development of more than 100 different reconstructive procedures. OBJECTIVE: To develop a standardized surgical approach to simplify selection of an adequate reconstructive procedure. MATERIALS AND METHODS: We performed a review of the literature and a retrospective analysis of 59 patients treated according to a standardized surgical approach over the past 5 years. RESULTS: By taking into account the anatomic location, the width of the defect, and the amount of tissue loss, three flowcharts have been developed to guide the physician to a selection of suitable reconstructive procedures for each case. CONCLUSION: This surgical approach facilitated the successful reconstruction of all encountered defects, and over a mean period of 31 months, no recurrences or major complications were seen.