A Case of Lip Cancer Arising from the Oral Commissure with Reconstruction by a Forearm Free Flap and an Advancement Flap of the Red Lip

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We report on a case of a 79-year-old female with squamous cell carcinoma of the lip. The tumor arose primarily from the oral commissure and invaded widely both the cutaneous and mucosal sides of the cheek. En block massive resection including the orbicularis oris muscle and also some parts of both the cutaneous and mucosal sides of the check was performed. The large defect was reconstructed with a combination of a forearm free flap and an advancement flap of the red lip. Using only a forearm free flap for a large defect may cause functional and cosmetic deformity problems. However, the combination of a free flap and a local flap is preferable for both a functional and cosmetic solution to these problems. Both the lip function and aesthetic appearance were satisfactory after the procedure. The patient also remains recurrence-free after the surgery. This technique should be considered as a valuable option for advanced lip cancer.