๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Flap design
Flap design
The surgeon should mark the vermillion border prior to infiltration of local anesthetic, as this margin often becomes distorted. Infraorbital or mental nerve blocks may be used to minimize some of this distortion. The flap is designed in a midline or paramedian location with a width that is approximately 50% the width of the defect. This helps to maintain the proportions of both lips, since closure of both the primary and secondary defects causes a similar reduction in width. The vertical height of the flap should be equal to the height of the defect. For extensive defects, an extended Abbe flap that includes skin beyond the mental crease has been described.21,22 Defects of the upper lip may be extended to replace the entire subunit and hide suture lines in the nasal sill or melolabial crease. A template is made and transferred to the desired location on the opposite lip. A medially or laterally based pedicle can be considered, but the side ipsilateral to the defect is often chosen to allow for a larger oral aperture postoperatively.