OBJECTIVETo investigate a novel method for the reconstruction of large vermilion defects.

METHODSBased on the size and shape of the defects, a buccinator myomucosal flap pedicled with the junction of buccinator and orbicularis oris in the oral commisure was designed and rotated to reconstruct the large vermilion defects. The upper bound of the flap is at least 1 cm away from the stensen's duct. The width is about 2.5-3.0 cm, and the length is as far as to arrive the raphe pterygomancibularis. The donate site is directly closed primarily. There is no need for secondary pedicle division.

RESULTSFrom July 2003 to April 2013, 14 cases with large vermilion defects was reconstructed with this method. No flap necrosis occurred with primary healing. 5 cases were followed up with an average follow up period of 1 year (0.5-3 years). The apprearance and function of the reconstructed vermilion were satisfactory without any apparent donor site defect. The patients were satisfied with both the functional and cosmetic results.

CONCLUSIONThe buccinator myomucosal flap is a simple and ideal method for reconstruction of large vermilion defects, especially for the defects closed to the commisure.