OBJECTIVETo investigate the reconstruction of wide vermilion and orbicularis oris muscle defect with satisfactory outcome of aesthetics, sensation, and function.

METHODSThe buccal musculomucosal flap based on the anterior buccal branches of the facial artery was used to reconstruct wide defect of vermilion and orbicularis oris muscle on upper or lower lip.

RESULTS7 patients were treated. 5 cases had no postoperative complication. Partial mucosal necrosis on the tip of the flaps happened in 2 cases, but the underlying muscle survived and was re-mucosalized spontaneously. No other complication was observed. The sensation of cold, heat and touch could be detected on the first postoperative day. Electromyographic and electron microscopic studies confirmed innervation of the muscle in the flap.

CONCLUSIONSThe buccal musculomucosal flap is a reliable reconstruction option for wide defect of vermilion and orbicularis oris muscle which can' t be reconstructed with conventional method. Satisfactory aesthetic and functional results can be achieved with the buccal musculomucosal flap.