Reconstruction of an Avulsive Upper Lip Wound Using a Cheek Rotation Flap Combined with a Muscle-Mucosal Advancement Flap: Case Report

Lip reconstruction presents a substantial challenge for plastic surgeons due to the importance of lips' essential tasks which include both functional performance (such as smiling, expression, oral competence, articulation among others) and aesthetic appearance. Lip defects result from trauma, neoplastic or congenital diseases. We present a 30-year-old male with an avulsive wound that affected the philtrum and the left upper vermilion secondary to a dog bite, with no bone injuries. He was admitted for antibiotic treatment, wound care and subsequently reconstructive management of the defect. After a 7th day treatment with clindamycin and wet to dry dressings patient was taken to the operative room. The surgery performed included a cheek rotation flap towards the lip at the level of the white roll, followed by an advancement flap of the red roll (muscle-mucosa) from right to left which allowed for coverage of the defect. The patient completed a 10-day course of antibiotics, accompanied by the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for analgesia, regular wound cleansing, subsequently demonstrating satisfactory clinical and aesthetic progress. Conclusion: The primary aim of labial reconstruction is to achieve adequate coverage of the vermilion and adjacent skin coverage in order to maintain an optimal balance between functional integrity and aesthetic outcome.