Subunit-Based Reconstruction of a Composite Upper Lip Defect After Dog Bite Using a Mucosal V-Y Advancement Flap and Nasolabial Fold Rotational Flap

Dog bite injuries involving the lips require careful reconstruction to restore both function and aesthetics. We report a case of a 64-year-old man with a composite defect of the upper lip after a dog bite. The defect involved the vermilion and extended to the adjacent cutaneous portion of the philtral column. Reconstruction was performed using a mucosal V-Y advancement flap for vermilionplasty and a nasolabial fold rotational flap for coverage of the cutaneous upper lip. This subunit-based approach restored both vermilion and cutaneous subunits using adjacent like-with-like tissue, resulting in satisfactory oral competence and favorable aesthetic integration, and may represent a useful alternative to skin grafting in selected upper lip defects.