Application of a subcutaneous tissue pedicle flap combined with a labial mucosa flap for reconstruction of full-thickness lower lip defects: a prospective observational study

Reconstruction of full-thickness lower-lip defects after skin cancer excision is challenging, as both oral function and appearance must be restored. Conventional methods may be insufficient for moderate-sized defects.
This prospective observational study included 36 patients with T1–T2N0M0 basal or squamous cell carcinoma (SCC) of the lower lip treated between January 2021 and April 2023. Defects involving roughly one-third to two-thirds of the lip were repaired using a combined subcutaneous pedicle flap and labial mucosa flap. Patients were followed for 6–24 months. Functional and aesthetic outcomes, wound healing, scar quality, and recurrence were assessed using standardized scoring systems.
Delayed healing was more common in patients over 70 years (37.5% vs. 5.0%). Defects > 2.0 cm had lower functional scores and higher delayed healing. Moist wound care reduced delayed healing compared with dry healing (exploratory). Tumor recurrence was 10.5% for SCC and 5.8% for BCC. Overall, functional and aesthetic outcomes remained high.
The combined flap technique is a safe, effective option for moderate-sized full-thickness lower-lip defects, providing reliable functional restoration and satisfactory cosmetic results.