Figure 3.

Submental flap used for reconstruction of lower lip and buccal defect. The patient underwent resection of an oral cancer involving the lower lip and buccal mucosa. Reconstruction was performed with a submental island flap. (A) Marking of the submental flap. (B) Marking of the submental flap and the course of the axial blood supply to the flap. The artery is marked after locating its course using a hand-held Doppler. (C) Submental flap after elevation. The instrument is pointing to the contralateral vein, which can be anastomosed at the recipient site if venous congestion is apparent. (D) Submental flap after inset for reconstruction of lower lip and buccal defect. Part of the flap can be excised in future procedures by advancing an upper and lower lip vermilion flap. (Parts B and C from Yazar S, Chen H-C, Mardini S. Augmentation of venous drainage by a venous anastomosis for pedicled flaps. Journal of Reconstructive Microsurgery 2008;24:369–376. Reprinted by permission.)