Facial plast Surg 2010; 26(6): 433-444
DOI: 10.1055/s-0030-1267717
© Thieme Medical Publishers

Lip and Perioral Trauma

Lisa Danielle Grunebaum1 , Jesse E. Smith2 , Gia E. Hoosien3
  • 1Departments of Otolaryngology/Facial Plastic and Reconstructive Surgery and Dermatology, University of Miami Miller School of Medicine, Miami, Florida
  • 2Department of Otolaryngology/Facial Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Center for Aesthetic Surgery, Colleyville, Texas
  • 3Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida
Further Information

Publication History

Publication Date:
17 November 2010 (online)

ABSTRACT

The management of perioral injuries is a complex topic that must take into consideration the unique anatomy, histology, and function of the lips to best restore form and function of the mouth after injury. Basic reconstructive principles include three-layered closure for full-thickness lip lacerations. Additionally, special care is needed to ensure an aesthetic repair of the cosmetically complex and important vermillion border, philtrum, and Cupid's bow. Infraorbital and mental nerve blocks provide lip anesthesia for laceration repair without distorting crucial aesthetic landmarks. Prophylactic antibiotics are usually indicated in perioral injuries due to wound contamination with saliva. Perioral burn management is controversial; however, most lip burns can first be managed conservatively. Splinting, plasties, and other reconstructive options are available after secondary healing of perioral burns. Hypertrophic scars are common in the perioral area after trauma. The mainstays of treatment for hypertrophic scars on the lips are silicone elastomer sheeting and intralesional steroid injections. For large perioral defects, a myriad of reconstructive options are available, ranging from primary closure, cross-lip flaps, and local tissue transfer, to free tissue transfers such as radial forearm free flaps, innervated gracilis free flaps, anterolateral thigh free flaps, and osteocutaneous free flaps.