Experts note that corner-of-mouth reshaping surgery primarily corrects conditions like facial asymmetry and drooping mouth corners. Two popular techniques are currently prevalent—let's explore them below!
Corner-of-Mouth Reshaping Methods
1. V-Y Advancement Flap Technique
Suitable for mild facial asymmetry without significant lip tissue loss.To achieve optimal results with this technique, preoperative assessment of perioral tissue laxity and glide potential is essential. A V-shaped incision is designed based on the deviation's location, direction, and severity. The position, angle, and arm length of the incision are determined accordingly.
The pedicle of the tissue flap is situated on the vermilion border side.During surgery, the V-shaped skin incision extends to the muscular layer. The tissue flap is elevated and advanced toward the vermilion border, secured with a Y-shaped suture. This ensures complete repositioning of the deviated lip tissue without excessive tension post-suturing. The Y-shaped suture not only directly closes the residual wound from the V-shaped flap but also prevents retraction of the flap along its advancement direction.
2. Z-plasty
Indicated for unilateral commissure displacement upward or downward due to scar traction, or unilateral commissure ptosis. For example, in upward commissure deviation, observe the patient's normal commissure position during mouth opening and closing. Design a Z-shaped incision whose limb length and angle of tissue flap insertion depend on the degree of deviation.
Note: The length of the incision along the vermilion border of the upper lip toward the midline should be such that when the resulting triangular flap is transposed and inserted into this incision gap, the deviated corner of the mouth is lowered to its normal height. The base of the resulting triangular flap should face outward, and its height should equal the distance the upwardly deviated corner of the mouth is lowered.Incising the skin down to the orbicularis oris muscle according to the design, elevating the flap, and inserting it into the upper lip incision with interrupted sutures.