Lip Repair after Mohs Surgery for Squamous Cell Carcinoma by Bilateral Tissue Expanding Vermillion Myocutaneous Flap (Goldstein Technique Modified by Sawada)

Alberto Goldman; Uwe Wollina; Katlein FranÃ§a; Torello Lotti; Georgi Tchernev

doi:10.3889/oamjms.2018.034

Authors

Alberto Goldman Clinica Goldman - Plastic Surgery, Porto Alegre/RS
Uwe Wollina StÃ¤dtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen
Katlein FranÃ§a Department of Dermatology and Cutaneous Surgery, Department of Psychiatry & Behavioral Sciences; Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL
Torello Lotti University G. Marconi of Rome - Dermatology and Venereology, Rome
Georgi Tchernev Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia; Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia

DOI:

https://doi.org/10.3889/oamjms.2018.034

Keywords:

Non-melanoma skin cancer, Squamous cell carcinoma, Lower lips, Flaps, Defect closure

Abstract

Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap. The original technique was modified by Sawada based on bilateral adjacent vermilion advancement flap for closure of central vermilion defects. We report the use of bilateral flaps - Sawadaâ€™s technique (instead of unilateral as suggested by Goldstein) in medium (2 cm of extension) to large defects (> 2 cm) to achieve an effective and functional reconstruction of vermillion defects after Mohs surgery for lip cancer.

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