Lip Reconstruction Principles

Aesthetic and Functional Considerations

The lips deserve special consideration due to their critical role in cosmesis and function, with distortion potentially resulting in significant functional and aesthetic impairment 1
Scars should be placed along natural boundaries when possible, such as the vermilion border or philtral columns 1
Debulking lip lesions while preserving vermilion can be exceedingly difficult due to the challenge of separating tissue from orbicularis oris muscle 1
Eversion of the lower lip may require excision of a mucosal strip, while correction of inversion may require a dermal implant or graft 1
Setting the "white roll" (ridge at the vermilion-cutaneous border) and restoring normal sublabial concavity can be particularly challenging 1

Lesions located exclusively on the vermilion can be removed using a transverse mucosal incision to hide the scar at the junction of the vermilion and vestibular mucosa 1
Lesions traversing both vermilion and cutaneous tissues may require a vertical incision 1
Early surgical resection may be considered for small lesions in cosmetically favorable areas 1
Bulkier lesions that cause lengthening of the lip or cross the vermilion-cutaneous border are best addressed using a wedge excision 1

Lubricate lips with lip balm or lip cream to promote healing 2
Maintain good oral hygiene with a soft toothbrush and mild fluoride-containing toothpaste 2
Avoid irritants that may delay healing, including spicy foods, hot foods and drinks, and citrus fruits 2