Long-term evaluation of Elmelegy's technique of local muscle transposition for the functional restoration of large upper or lower lip defects.

Background: Although more than 200 techniques have been reported for the reconstruction of the upper and lower lip defects since 1000 BC, none of them is ideal. Local flaps may result in extra skin incisions and in some cases, the surgeon may be confronted with the lack of sufficient tissues for the reconstruction of large defects. Several techniques have been described for near-total lip reconstruction. The two major available techniques are local flap reconstruction (Bernard-von Burrow-Webster technique) and free micro-vascular tissue transfer. In this study, we are going to evaluate the functional results of using local muscles transposition-assisted dermal fat flap and muco-buccal flap in the treatment of large upper or lower lip defects.

Materials and methods: This study was carried out on 128 patients, who presented to us with malignant tumors affecting the lips.

Results: Lip defect sizes ranged from 4 to 6 cm in diameter. No flap failure was seen and desirable function and accepted esthetic results were obtained. The flap survival was 100%, and healing was eventful in all cases. No cases of microstomia were reported.

Conclusion: The use of local muscle transposition-assisted dermal fat flap and muco-buccal flap technique, showed excellent results in regaining oral competence and lip mobility, and as much as possible, increased the aesthetic outcome.

Level of evidence: IV therapeutic study.