Combined Use of an Innervated Radial Forearm Flap and Labia Minora Peripheral Skin Graft for Total Upper Lip Reconstruction

The repair of a total lip defect and reconstruction of the vermilion border of the lip is challenging. Here, the authors report the successful functional and esthetic reconstruction of an injured upper lip using a free radial forearm flap and labia minora peripheral skin graft. A 43-year-old woman accidentally fell, resulting in a full-thickness wound in her entire upper lip. One month after the injury, the upper lip was reconstructed with an innervated free radial forearm flap. Six months postoperatively, a Semmes-Weinstein monofilament pressure esthesiometer indicated good recovery of neurosensory function with a value of 2.83. Nine months after the injury, the vermilion border, white roll, and philtrum were reconstructed. The vermilion border was reconstructed using a labia minora peripheral skin graft. The philtrum was reproduced using pigmented skin harvested from the vicinity of the labia minora, and the white roll was reconstructed 3-dimensionally by turning the dermis beneath the skin. Satisfactory results were obtained. The combined use of an innervated free radial forearm flap and labia minora peripheral skin graft may be an option for repairing extensive upper lip defects.