[The immediate reconstruction of a large lip-chin defect with two muscular pedicled and innervated island flaps (author's transl)].

Different methods of defect closure in the lipchin region through lateral advancement-flaps have been described by Bernard, Fries, Hertig, Meyer and others. Is there not enough material available, can neck-, breast-or forehead flaps cover the defect, although they do not fulfill the demands for a satisfactory restoration of specific function. In the following work is the possibility of covering of a three layered facial defect with a combined skin muscle flap taken into consideration in view of the disadvantages of a simple or doubled skin flap. By this operation method the procedure consists of preparing various sized cervical island flaps which are connected with on the mastoid pedicled M. sternocleidomastoideus. We are describing a case of extensive tumorresection in the lip-chin area with neurofibromatosis Recklinghausen, whereby we have closed a large defect with two separately laid on muscle-pedicled, innervated island flaps from the fossa supraclavicularis. These bilateral compound flaps fulfill the demands of an immediate restoration of contour and prominence in this area. Apart from this they allow satisfactory voluntary activity, unpleasant dribbling of saliva is prevented.