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  • Title: Gracilis free muscle transfer for morpho-functional reconstruction of the lower lip.
    Author: Cordova A, D'Arpa S, Moschella F.
    Journal: Head Neck; 2008 May; 30(5):684-9. PubMed ID: 17979111.
    Abstract:
    BACKGROUND: Large full-thickness defects of the lower lip need free tissue transfer. The free forearm flap is the more widespread technique for free flap lower lip reconstruction, but it results in a static lip. The authors describe a technique of morphodynamic sensate reconstruction of the lower lip with a free gracilis flap and a musculomucosal flap. METHODS: Three patients underwent reconstruction with an innervated free muscular gracilis flap, an innervated musculo-mucosal flap for the vermillion (2 cases), and a full-thickness skin graft. RESULTS: No significant complications were observed. Static function and vermillion sensitivity were immediately restored. The skin color match was excellent. After 9 months, contraction of the transferred muscle was evident. CONCLUSION: The lip is a dynamic unit. The innervated gracilis muscle seems ideal for lip reconstruction in that it correctly replaces all the lip layers and compensates for the lost function much better than a static technique.
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