11 - Lips and Chin
Published online by Cambridge University Press: 20 October 2009
Summary
The lips are comprised of the upper and lower lips with both a vermilion and a cutaneous component. The lips are bordered by the melolabial folds laterally, the nose superiorly, and the mental crease inferiorly. The reconstruction of the lips involves meticulous attention to both the cosmetic and functional outcome.
The movement of the lips results from the underlying orbicularis oris muscle, which functions as a sphincter. Fortunately, significant portions of the muscle can be removed and function restored with careful reapproximation. The vascular supply to the lips is rich and well anastamosed. The labial arteries course through the orbicularis muscle on the posterior aspects of the vermilion lip.
Although there are many important reconstruction concepts in the cosmetic appearance of the lip, two simple ones stand out. First is the need for careful reapproximation of the vermilion border. Marking the borders prior to the anesthesia is important. The second is keeping all incisions in the cosmetic junctions or the relaxed skin tension lines. The cosmetic junctions are the vermilion borders, melolabial folds, nasolabial junction, and mental crease. The relaxed skin tension lines emanate vertically in the central lip and radiate in a slightly lateral direction at the commissures. These can be seen readily when one purses the lips.
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- Color Atlas of Cutaneous Excisions and Repairs , pp. 157 - 170Publisher: Cambridge University PressPrint publication year: 2008