Platysma muscle cutaneous flap for large defects of the lower lip and mental region.

Based on the experience acquired using the depressor anguli oris flap for lateral lower lip reconstruction, the authors in this paper present their own technique to reconstruct large deficits of the lower lateral lip, involving the commissure and the mental region, by means of a platysma muscle cutaneous flap with a triangular skin island. The flap is oriented in the mandibular cheek region. The skin and the platysma muscle fibers, which run vertically, are incised and turned 90 degrees, so the edges of the platysma fibers are sutured to the edge of the residual orbicularis. The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa. The motor nerve and the vascular pedicle are preserved during the mobilization. The authors have treated six cases without relevant complication. A thorough knowledge of the anatomy of the region is mandatory; the surgical work must be precise and takes a long time, but results are highly satisfactory.