Jacono Andrew A, Bassiri Mike, Talei Ben
Department of Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, New York2Department of Otolaryngology/Head and Neck Surgery, Albert Einstein College of Medicine, New York, New York3Division of Facial Plastic and Recons.
Division of Facial Plastic and Reconstructive Surgery, New York Eye and Ear Infirmary, New York, New York.
JAMA Facial Plast Surg. 2015 May-Jun;17(3):219-23. doi: 10.1001/jamafacial.2015.18.
Defects of the central upper lip present a challenge. A variety of techniques have been described, but most tend to efface the natural contours present in the philtrum and the cutaneous-mucosal vermilion border (Cupid's bow). Furthermore, the techniques typically require a second-stage procedure to improve the upper lip aesthetic. We discuss a novel technique using bilateral transposition flaps to reconstruct central defects of the upper lip that violate Cupid's bow while maintaining normal aesthetic landmarks in a single stage. The mean angle of the transposition flaps was calculated.
A retrospective review of 7 patients was performed to identify those who underwent reconstruction of central upper lip defects at a Mohs reconstruction referral practice. Medical records from January 2009 to December 2013 were evaluated. The mean diameter of the final defect was 1.4 cm (range, 1.2-2.1 cm). The mean angle of the transposition flaps used was 50°. All defects were closed in a single stage with no secondary defect remaining. There was no need for a second-stage procedure.
The use of bilateral transposition flaps is a viable and preferred method for a single-stage reconstruction of the Cupid's bow and philtrum in central defects of the upper lip.
上唇中央缺损是一项挑战。已有多种技术被描述，但大多数往往会消除人中及皮肤黏膜唇红缘（丘比特弓）的自然轮廓。此外，这些技术通常需要二期手术来改善上唇美观。我们讨论一种使用双侧转位皮瓣重建侵犯丘比特弓的上唇中央缺损的新技术，该技术可在一期手术中维持正常的美学标志。计算了转位皮瓣的平均角度。
对7例患者进行回顾性研究，以确定那些在莫氏重建转诊机构接受上唇中央缺损重建的患者。评估了2009年1月至2013年12月的病历。最终缺损的平均直径为1.4厘米（范围为1.2 - 2.1厘米）。所使用的转位皮瓣的平均角度为50°。所有缺损均在一期手术中闭合，无继发性缺损残留。无需二期手术。
使用双侧转位皮瓣是上唇中央缺损一期重建丘比特弓和人中的可行且首选方法。
