Facial Plast Surg 2021; 37(04): 500-509
DOI: 10.1055/s-0041-1725110
Original Article

Lip and Perioral Trauma: Principles of Aesthetic and Functional Reconstruction

Yanjun Xie
1  Department of Otolaryngology—Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
,
Molly E. Heft Neal
1  Department of Otolaryngology—Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
,
Shannon F. Rudy
2  Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
,
Lisa D. Grunebaum
3  Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
,
David A. Shaye
4  Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
,
2  Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, Michigan
› Institutsangaben

Abstract

Successful management of lip and perioral trauma requires a nuanced understanding of anatomy and surgical techniques. Surgical correction is particularly challenging in instances of tissue loss, due to a narrow tolerance for aesthetic deformity and highly specialized functions of the perioral region, including facial expression, communication, and oral competence. Restoring continuity of the orbicularis oris musculature is critical for dynamic sphincter function of the upper and lower lips. Lip and perioral tissue symmetry are also critical for aesthetic balance, and failure to restore a natural appearance can adversely affect personal identity, with attendant psychological trauma. This discussion of lip and perioral trauma management encompasses lip and perioral anatomy, evaluation of injuries, reconstructive techniques, and prevention and management of complications. Perioral injuries are classified by size, depth, and extent of injury, and the corresponding reconstructive approaches are a function of complexity. These approaches proceed sequentially up rungs of the reconstructive ladder including primary repair, local flaps, grafting, regional flaps, as well as microvascular free tissue transfers. Procedures may be single stage or require multiple stages or subsequent refinement. Regardless of the defect size or location, the guiding principle of repair in the perioral region is restoring natural function and aesthetic appearance. This still-evolving area of facial plastic and reconstructive surgery lends itself to artistry and technical precision, offering opportunities for further innovation to improve the outcomes of patients with lip and perioral trauma.



Publikationsverlauf

Publikationsdatum:
22. Februar 2021 (online)

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