God is in the Details: Surgical Pearl for Lower Lip Wedge Resection

Abstract

Malignant tumours of the lower lip are common and wedge resections are frequently used to address these lesions. Since the lips are paramount for symmetry and overall aesthetics, even minor deformities can lead to disastrous changes. One of these could result from improper intra-operatory antero-posterior alignment between the anterior (cutaneous) and posterior (mucosal) vertex of the wedge, as the latter is not easily determined with precision by the naked eye. The authors present their surgical pearl to accurately define the vertex of the wedge in the posterior surface of the lip. A controlled, antero-posterior transmural penetration at a 90º angle is performed with a hypodermic needle. The entry point is the vertex of the cutaneous wedge. The sharp tip of the needle will now be the reference to the vertex of the mucosal wedge. This and others, easy-to-perform, although critical and frequently overlooked surgical pearls can help the dermatologic surgeon to avoid unwarranted sequelae on a cosmetic sensitive area such as the lips.