Bilateral Islanded Vermilion Myomucosal V-Y Advancement Flap for Large Central Lower Lip Defect

Abstract

Reconstruction of central lower lip defects requires restoration of oral competence while preserving esthetic balance. Dynamic reconstruction using residual lip tissue provides superior functional outcomes.

A 43-year-old male presented with a 2.9-cm traumatic central lower lip defect involving the vermilion, orbicularis oris muscle, and adjacent mucosa, with minimal cutaneous loss. Bilateral islanded myomucosal V-Y advancement flaps were designed from the remaining lateral lip elements and advanced medially to restore continuity. Muscle repair and mucosal closure were performed in layers.

Postoperative recovery was uneventful. At 2-month follow-up, the patient demonstrated satisfactory oral competence, symmetry, and acceptable esthetic outcome without microstomia or sensory deficit.

Bilateral myomucosal V-Y advancement flaps offer a simple, single-stage, and function-preserving option for reconstruction of selected central lower lip defects.