This case series brilliantly explains a novel technique to repair central upper lip deformities at a Moh’s reconstruction referral practice. Most of the current treatment operations advocate a secondary surgery in order to fully restore the philtral columns and the cutaneous mucosal vermilion border (Cupid’s bow). This article outlines the process of creating bilateral transposition flaps. These are created by locating the uppermost point of the philtral column and extending vertical incisions to the central defect. The lateral incisions are marked obliquely in a rhombi fashion from the initial superior points to ensure adequate pedicle length. The mean angle joining the vertical and lateral incisions of each transposition flaps was 50o. The flaps are then moved inferomedially to close the secondary defect. The pivot point creates a standing cutaneous deformity that recreates the apex of Cupid’s bow. Meanwhile as the donor area is focused on the philtral columns it helps camouflage the original site. Four patients’ pictures are shown before and 6-9 months after the procedure. The results are aesthetically pleasing which demonstrates why in patients with an adequate reservoir of skin superior to the central defect this technique is a viable surgical option.

Bilateral transposition lip flaps. A novel single-stage reconstruction of central upper lip defects involving cupid’s bow.
Jacono A, Bassiri M, Talei B.
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Bilal Gani Taib

University of Liverpool, UK.

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