Because some healthy tissue is removed along with the tumour in lip cancer surgery, a gap is left in the lip. Closing this gap — lip reconstruction — matters for keeping the mouth closed, for holding food in the mouth and speaking clearly, and for preserving the appearance of the face. This page describes the aims of reconstruction and the main methods used.
Aims of reconstruction
A good lip reconstruction pursues several goals at once:
- The mouth being able to close fully so that saliva or food does not leak out (oral competence)
- The mouth opening staying wide enough to allow eating and dental care
- Preserving sensation and movement in the lip as far as possible
- A smooth and symmetrical line of the red part of the lip (vermilion)
- Using tissue close to the natural colour and texture of the lip.
How is the method chosen?
The choice of method depends on how much of the lip the removed tissue covered, whether it was on the lower or upper lip, whether it involved the corner of the mouth (commissure), and the condition of the surrounding skin. The general principle is to obtain the best result with the simplest method; small defects are repaired with simple methods and large defects with flaps prepared from neighbouring tissue.
Direct closure
When a small part of the lip is removed, the remaining edges of the lip are stitched together layer by layer (lining, muscle, skin). Because lip tissue is elastic, this method usually gives a natural result without visible narrowing.
Local flaps
In larger defects, neighbouring lip or cheek tissue is moved into the gap while its own blood supply is preserved:
- Flap from the opposite lip: A defect in the lower lip can be repaired with a piece of tissue prepared from the upper lip (or the reverse). The tissue remains attached by a stalk for a while and is separated a few weeks later in a second small procedure.
- Cheek advancement flaps: Cheek tissue beside the corners of the mouth is advanced towards the lip to form a new lip.
- Nasolabial flaps: Tissue prepared from the skin fold between the side of the nose and the corner of the mouth is used particularly in upper lip reconstruction.
Free tissue transfer
When almost the whole lip has to be removed, tissue taken from a distant site such as the arm or leg can be moved to the lip, with its blood vessels joined to the vessels of the neck under a microscope. This method requires a longer operation and close monitoring, and it is combined with additional techniques to achieve mouth closure.
What to expect after reconstruction
Swelling, firmness and numbness of the reconstructed lip are normal in the first weeks; these decrease with time. The mouth opening may feel a little narrow at first; gentle stretching movements and, if needed, simple exercises improve this. Scars fade over months, and incisions placed along the line of the vermilion are usually barely noticeable. Small corrective procedures to improve symmetry or the corner of the mouth can be planned later.
Frequently asked questions
Is the lip repaired during the same operation?
Usually yes; the gap left after the tumour is removed is closed in the same session. Some flap methods require a second small procedure a few weeks later.
Will my mouth close normally after reconstruction?
The main aim of reconstruction is for the mouth to close fully and to hold food; in most patients these functions are largely regained once healing is complete.
Will the scars remain noticeable?
Incisions are placed along the natural lines and folds of the lip wherever possible; scars fade over months and usually become barely noticeable.
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.