The Possibilities and the Limits of the Abbe and Estlander Flaps in the Surgical Management of the Lower Lip Defects

Abstract

From the morpho-functional point of view, the lips are life indispensable, a complex unit with the main aesthetic role at the level of the face, the lower lip providing the most important part of the oral continence, with a psychological rebound. In some lower lip defects, the great challenge is the achievement of simultaneous reconstruction of the functions and an as natural as possible aspect. The flaps described by Abbé and Estlander, although classics, have maintained further very useful, providing almost perfect aesthetic and functional results. Being almost the same, they are composites, axial flaps, taken from the opposed lip, whose viability is dependent only on the compliance of the patient, which must be psychologically supported. New techniques combined with this type of flaps are welcome, especially in the cases when a big labial defect could appear. This paper is a review of these reconstructive techniques, described in comparison, also and with other loco-regional flaps. The explanation of their technical limits and disadvantages led to the conclusion that it is necessary to imagine, especially for large lip defects, new techniques by including this type of flaps into new combinations as optimized reconstructive versions - engine of the obtaining superior clinical outcomes.