Submandibular artery: Bilobed platysma myocutaneous flap for total lower lip reconstruction

BackgroundLower lip reconstruction following cancer resection includes a variety of clinical and microsurgical options.ObjectiveWe have developed a myocutaneous flap for full thickness reconstruction with a functioning muscle.TechniqueIn all patients, the submandibular artery was outlined using computerized tomographic angiography and Doppler. The flap was designed after resection. The first lobe was designed to fill the defect and was outlined 90° from the defect margin, with the submandibular artery in the center of the flap. A second lobe was then outlined 90° from the first lobe. The flap was raised along with the platysma muscle and artery, with the first lobe rotated to the lip and the second lobe inset into the first lobe site, permitting neck closure without skin redundancy.ResultsFrom January to May 2012, 17 patients were treated with this flap, and all flaps survived. All of the patients had oral continence at sixteen months, and electromyography documented platysma function.ConclusionThe flap provides single-stage lower lip reconstruction with functional muscle.