Bilateral Pedicled Mucosal Sliding Advancement Flap for Moderate Lower Lip Vermilion Defects Following Ablative Defects: A Technical Innovation.

Reconstruction of moderate lower lip vermilion defects remains challenging. We present a novel single-stage technique, the bilateral pedicled mucosal sliding advancement flap (BPM-SAF), which utilizes a horizontal relaxing incision above the vestibular sulcus to advance adjacent mucosa laterally. This retrospective single-center case series evaluated 10 subjects undergoing BPM-SAF reconstruction following tumor resection. Over a mean follow-up of 13.3 months (range, 1 to 31 months), all mucosal flaps survived completely. Donor sites healed smoothly via secondary epithelialization without infection, significant scar contracture, or microstomia. Postoperative oral competence and aesthetic appearance were highly satisfactory with well-restored vermilion contours. BPM-SAF represents a practical single-stage reconstructive option for moderate partial-thickness lower lip vermilion defects involving up to one-half of the lip width, when lip height, cutaneous tissue, and oral commissures are preserved, and adequate residual mucosal tissue is available. By maintaining bilateral vascular pedicles, the technique facilitates functional and aesthetic restoration while minimizing donor site morbidity.