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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2005;32(2):168-174.
Published online March 1, 2005.
Reconstructive Considerations in Webster's Modification of Bernard Operation after Wide Excision of Squamous Cell Carcinoma on Lower Lip.
Su Bong Nam, Yong Chan Bae, Chi Won Choi
Department of Plastic and Reconstructive Surgery, College of Medicine, Pusan National University, Busan, Korea. baeyc2@ hanmail.net
Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.
Keywords: Webster's modification of Bernard operation; Squamous cell carcinoma; Lower lip
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