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CC BY-NC 4.0 · Arch Plast Surg 2013; 40(01): 36-43
DOI: 10.5999/aps.2013.40.1.36
Original Article

Lower Lip Reconstruction after Wide Excision of a Malignancy with Barrel-Shaped Excision or the Webster Modification of the Bernard Operation

Hyung Joon Seo
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Seong Hwan Bae
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Su Bong Nam
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Soo Jong Choi
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Joo Hyoung Kim
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Jae Woo Lee
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
,
Yong Chan Bae
Department of Plastic and Reconstructive Surgery and Biomedical Research Institute, Pusan National University School of Medicine, Busan, Korea
› Author AffiliationsThis work was supported for two years by a Pusan National University Research Grant.
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Background Because there are numerous methods for reconstruction of the lower lip, it is not easy to choose the optimal method. In choosing the surgical method for lower lip reconstruction, we obtained acceptable outcomes based on our treatment strategy, which included either a barrel-shaped excision or the Webster modification of the Bernard operation. We report on the surgical outcomes based on our treatment strategy.

Methods This study included 26 patients who underwent lower lip reconstructive surgery from September 1996 to September 2010. The operation was done using either a barrel-shaped excision or the Webster modification, considering the location of the defect, the size of the defect, and the amount of residual tissue on the lateral side of the vermilion after excision.

Results In our series, 3 patients underwent a single barrel-shaped excision, and nine patients underwent a double barrel-shaped excision. In addition, the unilateral Webster modification was performed on in 6 patients, and there were eight cases of bilateral Webster modification. All of the patients except one were satisfied with the postoperative shape of the lip. In one case both recurrence and dehiscence occurred. One patient had a good postoperative lip shape, but had difficulty wearing a denture, and also underwent commissuroplasty. Furthermore, there were two patients who complained of drooling, and 4 with paresthesia.

Conclusions A soft tissue defect resulting from wide excision of a lower lip malignancy can be successfully reconstructed using only one of two surgical methods: the barrel-shaped excision or the Webster modification of the Bernard operation.

Keywords

Lip - Facial neoplasms - Reconstructive surgical procedures

This article was presented at the 69th Congress of the Korean Society of Plastic and Reconstructive Surgeons on November 11-13, 2011, in Seoul, Korea.




Publication History

Received: 04 October 2012

Accepted: 18 December 2012

Article published online:
01 May 2022

© 2013. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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