Repair of the Philtrum: An Illustrative Case Series

• Published in: Journal of cutaneous medicine and surgery Vol. 12; no. 6; pp. 288 - 294
• Main Authors: Housman, Tamara Salam, Berg, Daniel, Most, Sam P., Odland, Peter B., Stoddard, Earl
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-11-2008; Decker; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - therapeutic use; Biological and medical sciences; Carcinoma, Basal Cell - surgery; Dermabrasion; Dermatology; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Glucocorticoids - therapeutic use; Humans; Injections, Intralesional; Lip - surgery; Lip Neoplasms - surgery; Male; Medical sciences; Medical treatment; Middle Aged; Mohs Surgery; Plastic surgery; Postoperative Complications - drug therapy; Skin cancer; Skin Neoplasms - surgery; Skin Transplantation; Studies; Surgical Flaps; Time Factors; Treatment Outcome; Triamcinolone - administration & dosage; Triamcinolone - therapeutic use; Repair; Dermatology; Philtrum
• ISSN: 1203-4754; 1615-7109
• DOI: 10.2310/7750.2008.07043

Background:
Distortion of the philtrum, which lends considerable symmetry to the midface, leads to a poor esthetic outcome.
Objective:
This case series describes reconstructive approaches to six philtral defects after Mohs micrographic surgery. Reconstructive approaches including advancement flaps, full-thickness skin grafts, and second-intention healing are illustrated. Postoperative complications included graft hypertrophy, irregularity of the graft surface, graft color mismatch, tenderness, and slight eclabium, which improved with dermabrasion or intralesional triamcinolone.
Conclusion:
The reasonable success of full-thickness skin grafts demonstrated here provides an additional approach to philtral repairs, especially when combined with traditional advancement flaps.