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Upper Lip Reconstruction With Modification for Creating a Philtrum With Single-Stage Full-Thickness Skin Graft in Burned Face Injury

Yen, Cheng-I MD; Chen, Hung-Chang MD; Hsiao, Yen-Chang MD; Chang, Shu-Yin MD; Chuang, Shiow-Shuh MD

doi: 10.1097/SAP.0000000000001981
Burn Surgery and Research
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Background The philtrum plays an important role in determining the shape and form of the upper lip and creates individual identity. Postburn scar contracture in this area often leads to severe functional and aesthetic disfigurement. In this report, we present a novel method of philtrum reconstruction using full-thickness skin grafts (FTSGs) after burn injury.

Methods Between August 2011 and October 2017, 8 patients with postburn philtrum deformity who underwent FTSG for replacement of the whole upper lip unit with a silastic tube for creation of the philtral dimple were included. A review of photographic documentation was used to evaluate the aesthetic results.

Results The size of FTSG ranged from 4 × 9 to 6 × 17 cm. No patient had immediate postoperative complications, such as hematoma, infection, or necrosis. The crests of the ridges preserved their height and length, and the dimple remained visible after an average follow-up of 30.4 months (range, 3–69 months). All patients were satisfied with both functional and aesthetic results.

Conclusions This technique of single-stage reconstruction of the upper lip and philtrum with FTSG and silastic tube produced favorable results in the formation of the philtral ridges and the dimple. Through thoughtful preoperative design, meticulous scar release, and skin grafting, satisfactory functional and aesthetic results are achievable.

From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.

Received January 13, 2019, and accepted for publication, after revision April 15, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Shiow-Shuh Chuang, MD, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkuo, 5, Fu-Hsin St, Kwei-Shan, Taoyuan 333, Taiwan. E-mail: firepig@adm.cgmh.org.tw.

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