The upper and lower lips are the principle features of the lower third of the face and also the most anterior structures of the oral cavity. Together they comprise a very distinct and important anatomic and aesthetic unit. They are very necessary for facial appearance and for control of entry, retention or exit with respect to the oral cavity. With influence from the surrounding muscles of facial expression, the lips are normally capable of many different and important motions or expressions such as smiling, frowning, blowing, kissing, and whistling. Sensory functions of the lips are also very important to help monitor contacting or transiting materials for temperature and other characteristics and to allow enjoyment in functions such as kissing. It should be the goal of any reconstructive surgery to try to respect or restore the aesthetics and functions of the lip complex in the best possible manner.

From simple to complex, there are a large variety of reconstructive options that have been devised for reconstruction of the lip (1-4). The need for lip repair goes back to the very beginnings of surgical history (Fig. 1A and B). With the exception of free flap repairs, most of the lip reconstructions favored today have their roots in surgical literature from the mid-nineteenth to the early part of the twentieth centuries (1,4). The purpose of this chapter is to describe those procedures that are currently of particular importance and try to offer guidance in choosing a method of repair.

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