"Hammock" Mucosal advancement flaps:a new reconstruction method for lip defects

Lips play a crucial role in facial aesthetics, and lip defects not only impact appearance but also function. Repairing lip defects has long been a big challenge for surgeons. Currently, "V" shaped excisions are commonly employed in lip tumor surgeries, encompassing both the lesion and surrounding normal tissue, which facilitates wound closure. However, this technique may result in the loss of transverse lip width, leading to microstomia and affecting aesthetics. Additionally, the removal of a significant amount of normal tissue can result in noticeable vertical scars. To address these limitations, especially for vermilion defects, we propose a novel reconstruction method using "hammock" mucosal advancement flaps. This technique involves creating bilaterally pedicled sliding mucosal flaps, fixed at both ends with the middle part capable of lateral movement, resembling a hammock, hence the name "hammock" mucosal advancement flaps. This method effectively repairs vermilion defects without reducing transverse lip width, thereby preventing microstomia. A retrospective analysis of patients who underwent this procedure showed satisfactory outcomes, with patients expressing high satisfaction with their lip appearance. Although laterally based bipedicled flap technique was initially described by Wilson et al., in 1981, it appears to have been largely overlooked in contemporary practice. Based on our findings, we firmly believe that the 'hammock' mucosal advancement flap demonstrates substantial clinical value in lip defect reconstruction. We hope that our work will contribute to renewed interest in this technique and encourage its wider adoption in clinical practice.