The patient has a squamous cell carcinoma involving almost one half of the lower lip.
A "V" shaped incision is outlined to resect the cancer. The tip of the "V" does not cross the skin crease between the lip and the chin.
A flap from the upper lip equal to one half the defect is outlined. It is based medially on the superior labial artery.
Using a #11 blade the cancer is removed. The technique used is that described in the "V" Resection Surgical Presentation.
The upper flap is rotated into position. Great care is taken not to cut the superior labial artery.
Near the artery only the skin is cut. Blunt dissection is used to divide the deep tissues to lessen the chance of injuring the artery.
The flap is sewn in place and the donor site closed using a 5-0 Nylon Stitch.
If the patient has dentures, be sure they are taken out prior to surgery.
The appearance one day after surgery.
The appearance one week after surgery.
The appearance six weeks after surgery.
The planned incisions to release the flap. The flap will be divided and the margin of the flap is rotated into the lateral lip to align the vermillion cutaneous junction.
This picture shows the closure after the second and final stage of the reconstruction.
The three month post operative result with the lip at rest.
( The next slide shows the function of the lower lip )
Three month postoperative result with the patient whistling. Note that innervation and function has returned to the flap.
Listen to the patient whistling.
Abbe Estlander Flap for Lip
Reconstruction in a
Patient With Skin Cancer of the Lower Lip
This flap has a named artery and an
excellent blood supply. The pedicle of the flap is very small. The biggest
disadvantage is that two operations are required and the patient must have his
lips sewn together for 4 to 6 weeks. The blood supply to this flap is from the
superior labial or inferior labial artery, both are branches of the facial
artery and are of the external carotid artery system. The flap is usually
based medially, otherwise it may be very difficult to rotate into position.
Play to Hear Patient Whistle After Surgery:
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The patient has a squamous cell carcinoma involving almost one half of the lower lip.
A "V" shaped incision is outlined to resect the cancer. The tip of the "V" does not cross the skin crease between the lip and the chin.
A flap from the upper lip equal to one half the defect is outlined. It is based medially on the superior labial artery.
Using a #11 blade the cancer is removed. The technique used is that described in the "V" Resection Surgical Presentation.
The upper flap is rotated into position. Great care is taken not to cut the superior labial artery.
Near the artery only the skin is cut. Blunt dissection is used to divide the deep tissues to lessen the chance of injuring the artery.
The flap is sewn in place and the donor site closed using a 5-0 Nylon Stitch.
If the patient has dentures, be sure they are taken out prior to surgery.
The appearance one day after surgery.
The appearance one week after surgery.
The appearance six weeks after surgery.
The planned incisions to release the flap. The flap will be divided and the margin of the flap is rotated into the lateral lip to align the vermillion cutaneous junction.
This picture shows the closure after the second and final stage of the reconstruction.
The three month post operative result with the lip at rest.
( The next slide shows the function of the lower lip )
Three month postoperative result with the patient whistling. Note that innervation and function has returned to the flap.
Listen to the patient whistling.
