Upper Lip Lift Excision Used as Full-Thickness Skin Graft for Mohs Reconstruction of the Philtrum

A Case Report

David Steckler, MD; Colin Fernstrum, MD


ePlasty. 2022;22(e57) 

In This Article

Abstract and Introduction


Background: Upper lip defects pose a significant challenge for the reconstructive surgeon to produce an aesthetically pleasing result.

Case Presentation: This article reviews 2 cases of middle-aged women who underwent upper lip lift excisions that were used as full-thickness skin grafts for reconstruction of philtral defects after Mohs excision of cutaneous carcinomas.

Conclusions: Using the upper lip lift as a full-thickness skin graft donor site can result in superior results to other donor sites for reconstruction of philtral defects.


Plastic surgeons are often tasked with treating soft tissue defects of the face, and they are judged not only by the successful reconstruction of the defect but by the final aesthetic appearance of the reconstruction. Many reconstructive techniques have their advantages and flaws, with wide variations in donor site morbidity. Previously described aesthetic boundaries of the upper lip limit the utility of local flap reconstruction in certain areas because of evident scarring and vermilion distortion.[1]

Multiple techniques have been described for upper lip reconstruction, including secondary intention, excision and primary closure, full-thickness skin grafts, and local flaps or a combination of these.[2,3] Full thickness skin grafts have been popularized especially in reconstruction of philtral defects, as long as they do not cross the philtrum. A key principle in reconstructive surgery is to replace defects with like tissue. Usually, the best color matches for upper lip reconstruction are preauricular skin, forehead skin, or other portions of the lip.[2]

The lip lift was first described by Austin[4] in 1986 as a "wavy ellipse on the upper lip skin following the contours of the base of the nose", leading to a lifted, more pronounced, and fuller appearing upper lip. Since that time, there have been multiple modifications and advancements described.[5–7] This paper presents a case of upper lip reconstruction after Mohs resection of cutaneous malignancy using the excised skin from an upper lip lift as a full-thickness skin graft. To our knowledge, this technique has not yet been described in the literature.