A submental advancement flap whose superior margin is the mental sulcus can be used for resurfacing the chin. Excision of most of the anatomic unit of the chin is marked out (Fig. 121.1A). As much skin and deeper tissue as necessary is removed for complete tumor excision. The fat pad will be carried with the submental skin to help carry the blood supply.

Figure 121.1B shows the outline of the submental flap. The submental keyhole-like flap was elevated to the junction with the neck. The lateral triangles produced by the configuration of the flap (Fig. 121.1C) were sutured together to advance the submental flap. The neck then was slightly flexed and the flap advanced to the mental sulcus. Subcuticular sutures were used at the base of the flap to advance it distally and to release pressure at the distal suture line (Fig. 121.1D).