Bipedicle Submental Skin Flap
V. Y. BAKAMJIAN
INDICATIONS
The same cervical skin flaps that were described for intraoral lining (see Chapter 188) are easily applied for both the external and internal coverage of facial defects (1). Cervical skin flaps also provide distinctly cosmetic advantages—those of matching color, texture, and degree of hairiness with facial skin.
FLAP DESIGN AND DIMENSIONS
Two mirror-image flaps of a transverse or slightly oblique projection meeting across the midline form a particularly safe bipedicle variant that may be very useful for chin and lip area applications. The central segment of the bipedicle flap is applied to the area of reconstruction; the pedicles are tubed as carriers on each side.
 FIGURE 122.1 Bipedicle submental skin flap to lower lip. A: Squamous cell carcinoma. B: Lower lip total resection. C: Skin flap supplying outer layer and lingual flap providing inner layer and vermilion for the new lip. D: Submental closure of the donor wound. E: Final result. (From Bakamjian, ref. 1, with permission.)
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