A case of vermilion reconstruction using a facial artery musculomucosal flap

Facial artery musculomucosal (FAMM) flaps are musculomucosal flaps based on the facial artery. These flaps consist of mucosa, submucosa, a small amount of buccinator muscle, the deeper plane of the orbicularis oris muscle, the facial artery, and the venous plexus. We describe the use of a FAMM flap for the repair of a vermilion defect after resection of a lower lip carcinoma. A 62-year-old man with an ulcer and mass of the lower lip was referred to our hospital. The pathological diagnosis was squamous cell carcinoma. He underwent tumor resection and vermilion reconstruction using an FAMM flap. We identified the facial artery by Doppler ultrasound. The FAMM flap was designed superiorly to Stensen's duct. The flap was elevated and rotated inferiorly. Then, the defect of the vermilion was covered. The donor site was closed primarily. Although the tip of the FAMM flap underwent partial necrosis postoperatively, the flap survived after conservative treatment. An FAMM flap is useful for repairing defects in the vermilion, although only a flap of limited size can be harvested.