A Comment on: “Lip reconstruction using superficial flaps: functional and aesthetic integration”

Funding: None
Conflict of interest: None
Submitted on: 05/24/2026
Final decision: 05/27/2026
How to cite this article: Aydin MS, Özler G. A Comment on: “Lip reconstruction using superficial flaps: functional and aesthetic integration.” Surg Cosmet Dermatol. 2026;18(2):e20260586.

Abstract

This Letter to the Editor comments on the article “Lip reconstruction using superficial flaps: functional and aesthetic integration.” The reported case series provides valuable clinical examples of individualized superficial flap selection for upper and lower lip reconstruction following excision of non-melanoma skin cancer. We emphasize the importance of tailored reconstructive planning while suggesting that objective functional outcome measures and clearer flap-selection criteria could further strengthen the translational impact of the study.

Keywords: Plastic Surgery Procedures; Surgical Flaps; Dermatologic Surgical Procedures

We read with great interest the article by Aita et al. entitled “Lip reconstruction using superficial flaps: functional and aesthetic integration.” The authors are to be commended for presenting a well-structured case series demonstrating the successful use of multiple superficial flap techniques for reconstruction of upper and lower lip defects following surgical excision of non-melanoma skin cancers.

The main strength of the manuscript lies in its clinically oriented and individualized approach to reconstructive planning. The selection of mucosal rotation flaps, double V-Y advancement flaps, and O-Z rotation flaps according to defect characteristics reflects sound surgical reasoning and adherence to established principles of lip reconstruction. The emphasis on preserving oral sphincter function and maintaining aesthetic subunits is particularly relevant in perioral reconstruction, where both functional and cosmetic outcomes are critical.

The variety of techniques presented offers useful practical guidance for surgeons managing similar defects in routine practice. In particular, the successful application of double V-Y advancement flaps for central lip defects and O-Z rotation flaps for more complex reconstructions highlights the versatility of superficial flap techniques in achieving both symmetry and functional preservation.

However, the manuscript could be strengthened by the inclusion of more objective functional outcome measures. Although photographic documentation provides valuable evidence of aesthetic success, standardized assessments of oral competence, speech articulation, and sensory recovery would enhance the clinical robustness of the reported outcomes. In addition, a more detailed discussion of the indications, limitations, and selection criteria for each flap type would further improve the translational value of the study and assist surgeons in preoperative decision-making.

In conclusion, this case series makes a meaningful contribution to the existing literature on lip reconstruction and reinforces the importance of tailoring reconstructive strategies to defect characteristics and functional requirements. l

AUTHOR’S CONTRIBUTION:

Muhammed Said Aydin
ORCID: 0009-0001-9374-3131
Approval of the final version of the manuscript, Critical review of the literature, Acquisition, analysis and interpretation of data, Critical revision of the manuscript, Preparation and writing of the manuscript, Conception and design of the study.
Gökay Özler
ORCID: 0009-0002-7217-3894
Approval of the final version of the manuscript, Critical review of the literature, Critical revision of the manuscript, Conception and design of the study.

REFERENCES:

1. Aita VH, Prócel C, Jacques NS, Cafrune FE. Lip reconstruction using superficial flaps: functional and aesthetic integration. Surg Cosmet Dermatol. 2026;18(1):e20260480.

2. Chellappan B, Obanigba G, Hoyer P, Ross L. Lip reconstruction after Mohs micrographic surgery: a guide on flaps. Cutis. 2023;111(4):205-9.

3. Shim GJ, Yoon HW, Kim D, Kwon TG. Reconstruction of an upper lip vermilion defect with a mucosal V-Y advancement flap: a case report. J Korean Assoc Oral Maxillofac Surg. 2024;50(4):222-6.

4. Lee TY, Shin YH, Choi DI. Reconstruction of medial epicanthal fold using V-Y advancement and turnover flap. J Plast Reconstr Aesthet Surg. 2020;73(2):363-8.