A new technique for total reconstruction of the lower lip in a patient with malignant melanoma.

A very rare case of malignant melanoma of the lower lip was presented. While there are many concepts and techniques for reconstruction of the lower lip including advancement flaps, switching flaps, rotation flaps, and regional flaps from the cheek, upper lip, tongue, forehead, neck, and chest, no single flap is ideal in every instance. Lower lip reconstruction utilizing a modification of bilateral nasolabial flaps has been described. The distinct advantages of utilizing myocutaneous flaps in a Z augmentation manner, including the maintenance of good functional competence of the lower lip, maintenance of adequate oral commissure diameter, and a good cosmetic result, have been demonstrated. While no single technique for reconstruction of the lower lip is ideal for every case, we feel that the method presented here offers a very good option when faced with the challenge of complete reconstruction of the lower lip.