Upper and Lower Lip Reconstruction Using the Step Technique

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Abstract
The step technique for lip reconstruction is a simple, flexible, one-stage operation that allows reconstruction of full-thickness defects spanning up to two-thirds of the lower lip and, in our experience, one-half of the upper lip without violating the opposite lip or using distant advancement flaps. Twelve patients, ranging in age from 24 to 86 years, underwent full-thickness lip excisions for squamous cell and deeply invading basal cell carcinomas. Reconstruction was achieved by advancing the remaining lateral lip elements to close the defects in a stepwise fashion without violating the remaining orbicularis oris muscle. All patients had a symmetrical, mobile, oral sphincter with intact commissures, adequate buccal sulcus, no symptomatic microstomia, and normal sensation at the completion of the procedure. There have been no recurrences in a nine-month to four-year follow-up, and satisfactory aesthetic results were achieved.

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