Answer:
(From Grabb and Smith CD-ROM:)

 

Defects Involving Less Than 30% of the Upper Lip:
The goals in reconstructing defects <30% of the upper lip include the correct alignment of the vermilion and the white roll and the reapproximation of the orbicularis oris muscle.

The Bernard operation may be modified for large full-thickness lateral defects, as well as for reconstructing the full upper lip. Large lateral defects of the upper lip may also be closed with lip-switch flaps, or lower triangle excision and sulcus release.

The Webster Modification, a.k.a. the “physiologic” repair, of the Freeman technique for lower lip reconstruction provides principles that may be applied for both lower lip defects and complete upper lip repairs. This repair requires that the tumor be excised as a quadrilateral segment. Flaps of buccal mucous membrane are left and will provide the new vermilion for the reconstructed lip. The vertical suture lines may be interrupted by Z-plasty. The offset closure methods prevent notching of the lip. In this way, innervated muscle is brought into the new lip to provide a sensate, watertight, and functional lip that is cosmetically reasonable. Bilateral nasolabial flaps may also be used for total upper lip skin repair.
 

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