Reconstruction of a Large Lower Lip Defect Including Vermilion Using a V-Y Advanced Flap Combined with a Musculomucosal Stacked Flap

Summary: Reconstruction of large lower lip defects is challenging, especially when repairing the vermilion at the same time. The authors describe a novel method for reconstruction of a large lower-lip defect including the vermilion. The reconstruction includes two layers: the anterior layer, reconstructed from V-Y advanced musculocutaneous flap of the cheek; and the posterior layer, reconstructed from the musculomucosal flap from the remnant lower lip. Stacking of the bilateral musculomucosal flaps raises the height of the posterior layer and covers the top of the lower lip to form the new vermilion. This is a simple and reliable method with satisfactory cosmetic and functional results.