Bilateral Transposition Lip Flaps: A Novel Single-Stage Reconstruction of Central Upper Lip Defects Involving Cupid's Bow.

Importance: Defects of the central upper lip present a challenge. A variety of techniques have been described, but most tend to efface the natural contours present in the philtrum and the cutaneous-mucosal vermilion border (Cupid's bow). Furthermore, the techniques typically require a second-stage procedure to improve the upper lip aesthetic. We discuss a novel technique using bilateral transposition flaps to reconstruct central defects of the upper lip that violate Cupid's bow while maintaining normal aesthetic landmarks in a single stage. The mean angle of the transposition flaps was calculated.

Observations: A retrospective review of 7 patients was performed to identify those who underwent reconstruction of central upper lip defects at a Mohs reconstruction referral practice. Medical records from January 2009 to December 2013 were evaluated. The mean diameter of the final defect was 1.4 cm (range, 1.2-2.1 cm). The mean angle of the transposition flaps used was 50°. All defects were closed in a single stage with no secondary defect remaining. There was no need for a second-stage procedure.

Conclusions And Relevance: The use of bilateral transposition flaps is a viable and preferred method for a single-stage reconstruction of the Cupid's bow and philtrum in central defects of the upper lip.