The Upper Lip Partial Subunit Superiorly Based Orbicularis Oris Sling Flap to Repair Upper Cutaneous Lip Defects.

BACKGROUND

The traditional V-Y advancement flap to repair upper cutaneous lip defects may cause a fat lip or a noticeable oblique scar within the cosmetic subunit. The upper lip partial subunit superiorly based orbicularis oris sling flap is a novel modification that reduces lip fullness and hides scars along cosmetic subunit junctions.

OBJECTIVE

To describe the technique and aesthetic outcomes in a cohort of patients with upper cutaneous lip defects repaired with the upper lip partial subunit superiorly based orbicularis oris sling flap.

METHODS

A retrospective case series was performed of consecutive patients with lateral upper cutaneous lip defects reconstructed with the upper lip partial subunit superiorly based orbicularis oris sling flap from 2006 to 2021. Three independent observers graded lip symmetry and rated scar appearance with the Patient and Observer Scar Assessment Scale (POSAS).

RESULTS

Fifty-two patients were included. Independent observers favorably rated scar appearance with an average composite POSAS score of 6.9 (SD: 1.5) on a scale of 5 (normal skin) to 50 (worst possible scar). Lip symmetry was most commonly graded as excellent (80.8%) or good (13.5%). Surgical scar revision was infrequent.

CONCLUSION

The upper lip partial subunit superiorly based orbicularis oris sling flap reduces lip fullness and hides scars along the upper lip cosmetic subunit junctions.