Transverse V-Y Mucosal Advancement Flap for Reconstruction of Labial Mucosal Defects: A Clinical Application

Abstract

OBJECTIVE: To evaluate the clinical efficacy of the transverse V-Y advancement mucosal flap for reconstruction of small- to medium-sized lip mucosal defects. METHODS: Clinical data from 17 patients who underwent reconstruction of lip mucosal defects following resection of benign or early-stage malignant lip lesions between June 2017 and October 2025 were reviewed. Triangular mucosal flaps were designed on 1 or both sides of the defect while preserving a deep tissue pedicle ∼1.0 cm in width. The mucosal flaps were advanced horizontally toward the center of the defect and inset using V-Y closure, while the donor sites were closed primarily. Flap survival, postoperative complications, and functional and aesthetic outcomes during follow-up were evaluated. RESULTS: All 17 transverse V-Y advancement mucosal flaps survived, and all wounds achieved primary healing. The defect sizes ranged from 1.5×1.5 cm to 2.0×2.5 cm. The median follow-up duration was 15 months (6-28 mo), during which no recurrence was observed. All patients achieved satisfactory postoperative lip symmetry, with normal mouth opening and preserved lip mobility. The flaps showed excellent tissue integration, demonstrating satisfactory color and texture match, and no obvious complications, such as scar contracture, were observed. CONCLUSION: The transverse V-Y advancement mucosal flap is a reliable reconstructive technique characterized by flexible design, technical simplicity, minimal donor-site morbidity, and robust vascularity. It effectively uses adjacent redundant mucosal tissues to avoid dog-ear deformity and additional tissue injury. Therefore, it represents an effective and reliable option for reconstruction of small- to medium-sized partial-thickness mucosal defects of the lip.