Reconstruction of Near-Total Loss of the Upper and Lower Lips due to Purpura Fulminans with Local Tissue and a Dual-Skin Paddled Anterolateral Thigh Flap

Summary:. It is difficult to totally reconstruct the lip, achieving good functional and aesthetic results. There have been few reports of reconstructing complete lip defects. Moreover, upper and lower lip necrosis by purpura fulminans has not been reported. We present a case of a 60-year-old male purpura fulminans patient with upper and lower lip necrosis. Fortunately, our patient had retained his oral commissure function. We reconstructed this defect with an orbicularis oris muscle-skin-mucosal pedicled flap derived from the region between the nasolabial folds for upper lip; a similar bipedicled flap for the lower lip and the donor site was closed with a dual-skin paddled anterolateral thigh flap. Postoperative results were satisfactory, that is, no lip tightness or aperture restriction was seen, and symmetry had been achieved. The new lips exhibited complete sensory recovery. Drooling was minimal during rest and feeding. We could select a method that combined the advantages of local and free flaps. We consider our method for this defect is superior to those described in previous studies, in that the restoration of lip sensation and oral sphincter function can be achieved to some extent in 1 stage while preserving the oral commissure function

A Case of Abdominoplasty after Removal of Giant Ovarian Cyst

Summary: When treating a giant ovarian cyst, management of inferior vena cava (IVC) syndrome, bleeding, abdominal competence, and cosmetic appearance are difficult. The details of abdominoplasty for patients with such a cyst have not been discussed. We present a patient requiring 85,000 ml of fluid evacuation before surgery

Function Preservation of the Upper Lip after Tumor Resection Using Residual Orbicularis Oris Muscle and Attached Levator Labii Superioris Alaeque Nasi

Summary:. We report a case, function preservation of the upper lip after tumor resection was possible using residual orbicularis oris muscle and attached levator labii superioris alaeque nasi. Patient was 67-year-old male with squamous cell carcinoma at the vermilion border. The tumor was resected with an 8-mm margin, leaving the oral mucosa as intact as possible. To reconstruct the red lip, we used the oral mucosa as a rotational transposition flap. The white lip was reconstructed with a cheek rotation flap. A levator labii superioris alaque nasi muscle flap, which was attached to the remaining orbicularis oris muscle, was used to increase marginal lip volume. The movement of the reconstructed lip was good. At 9 postoperative months, induration of the red lip was palpable, and we suspected that the blood supply to the levator labii superioris alaque nasi was borderline insufficient. Slight drooping of the reconstructed lip occurred. We dissected this was caused by dissection of mid facial muscles from orbicularis oris muscle to ease downward rotation of the cheek flap and obscure the original nasolabial fold. Although some drooping and induration of the lip occurred, the white and red lip were reconstructed in a single-stage procedure, which resulted in good movement and preserved the function of the orbicularis oris muscle