Lip Lift Flap for Columella Reconstruction.

BACKGROUND

The columella is highly susceptible to damage and the most challenging nasal subunit to reconstruct. Of existing reconstructive techniques, ranging from regional to microsurgical flaps, none are ideal for minimizing the complexity of flap harvest and donor site morbidity. This article describes an alternative local flap for focal columellar defects without other subunit soft tissue defects: lip lift flap.

METHODS

A retrospective review was conducted of the senior surgeon's patients between July 2022 and September 2023. Patients who underwent the lip lift flap were identified, and their demographics, surgical details, and outcomes were indexed. This modified operative technique for columellar reconstruction is proposed by presenting a case series and literature review.

RESULTS

Three patients from a single surgeon had sustained total columellar loss without tip subunit involvement. In all cases, there was subjective aesthetic improvement and excellent color and texture match. No complications were seen, including no poor donor site scarring or flap necrosis. In all cases, coverage of the central and lateral columellar walls was achieved. Costal cartilage strut grafts were able to be placed simultaneously without compromising neovascularization and with complete coverage.

CONCLUSION

The application of the lip lift flap was able to provide skin and soft tissue coverage for restoring columellar length and strength with satisfying aesthetics.