Due to complex functional and cosmetic importance of the lips, the reconstruction of the resulting lip defects has always been a challenge for reconstructive surgeons. Many surgical techniques have been described in the literature to reconstruct such defects; each has its own advantages and disadvantages. We aimed in this study to evaluate the use of the Webster flap in reconstruction of large full-thickness lower lip defects after tumor resection with regard to functional and esthetic outcomes. A prospective study was conducted between Feb 2013 and Feb 2016 on 15 patients (9 males, 6 females), with mean age of 60.7 years, with large full-thickness lower lip defects following resection of SCC and were reconstructed by the Webster flap (3 unilateral and 12 bilateral flaps). The commissure was involved in 6 patients (40%). All patients were evaluated for early postoperative wound complications and for late results regarding the functional aspect of the repair in terms of oral competence and size of the oral stoma. As for esthetic outcome, objective assessment was done and graded as excellent, good and poor. Routine oncologic follow up was done for all patients. All flaps survived completely, while minor cutaneous dehiscence occurred in 2 patients (13.3%). None of our patients developed microstomia. Six patients (40%) developed temporary incontinence to oral fluids and two patients (13.3%) had drooling. Complete recovery of all functional changes occurred within 8-10 weeks. The final esthetic outcome was excellent in 5 patients (33.3%), good in 8 patients (53.3%) and poor in 2 patients (13.3%). The follow up period ranged from 6 to 24 months (mean -13.8 m). We can conclude that the Webster flap is highly effective single-stage procedure for reconstruction of large full-thickness lower lip defects, which has the advantages of preservation of oral competence and maintenance of adequate mouth opening. Moreover, it provides good esthetic outcomes at rest and function.
 

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