Versatile use of submental tissue for reconstruction of perioral soft tissue defects

To obtain optimum aesthetic result, perioral soft tissue defects require reconstruction using similar tissue. The submental area has very similar characteristics to perioral soft tissue and consists of thin, pliable tissue with a perfect color match. Therefore, we have used submental tissues for reconstruction of perioral soft tissue defects and application of the techniques, and results are discussed in this article. Between February 2001 and April 2008, 14 perioral soft tissue reconstruction procedures using the submental tissues were performed. The defect was on the upper lip including nasal columella in 5 cases, mentum in 3 cases, and oral commissure including buccal cheek in 6 cases. The techniques that were used included composite graft in 3 cases, local advancement flap in 3 cases, pedicled flap in 5 cases, and free flap in 3 cases. Patients were followed up for 9 months to 5 years. During this period, no major complications were noted, and satisfactory aesthetic results were obtained. All transferred submental tissues survived. In all patients, donor defects were closed primarily except in cases of local advancement flap. The donor-site scar was inconspicuous and well hidden below the mandibular margin and did not restrict neck motion in all patients. In particular, hair restoration on the flap was excellent in male patients. We believe that the submental area can provide useful soft tissue for perioral soft tissue defects because it provides a good color and texture match with perioral skin and can be harvested with minimal donor-site morbidity.