Webster Flap Modification for Lip Reconstruction: Surgical Technique

The modified Webster method was used in the two cases after lip cancer surgery. In the first case, the defect included two thirds of the lower lip and extended to the commissure. A lower lip vermillion and commissure were created by the excision of the upper nasolabial trigone skin in which a second flap was formed from the mucosa and muscle tissue. One month later, the excess mucosa tissue was removed by resection following the evaluation of the relation between the upper lip, lower lip and commissure. In the second case with upper lip total defect, a new technique was used for the first time in which total upper lip reconstruction was accomplished by upper nasolabial Burow trigone excision and lower labiomental Webster flap modification. As the Burow trigone excision was per-formed, the alar-facial skin tissue was left in place in order to enable the filtrum reconstruction if necessary. The functional continuity of the lower lip was protected by performing the trigone skin excision at a location far from the lip commissure towards the labiomental area. The esthetic appearance as well as lip function was satisfactory in both cases; however, more cases are needed to carry out prospective clinical research.