Strategy to minimize oral mucosal tear and lip injury in facial contouring and orthognathic surgery.

In this article, the authors present a simple but effective technical strategy to protect the lip and mucosa from iatrogenic thermal injury and traumatic mucosal tear in orthognathic and aesthetic facial contouring surgery. During surgical exposure and osteotomy, a piece of double-layered Vaseline dressing gauze is strategically placed over the lip and mucosal tissues before the application of the Obwegeser or Gimma retractors. The objective is to avoid traumatic and thermal injury to the lip and mucosal tissues during the use of various retractors and other craniomaxillofacial dynamic instruments in such surgery. In our experience of consecutive 400 intraoral osteotomy procedures over the last 5 years of using the double-layered Vaseline gauze to protect the lip tissues and oral mucosa, there was no incidence of any unintentional complications of thermal injury and tears of the lip and mucosa. It is simple and effective with minimum learning curve, but most importantly it has significantly minimized the morbidity associated with lip thermal injury and mucosal tear in these patients.