Product Description

This case report presents a 75-year-old male with well-differentiated squamous cell carcinoma (SCC) of the lower lip, initially managed with surgical excision and primary closure, followed by adjuvant radiation for perineural invasion. One year later, the patient experienced a local recurrence at the previous surgical site. Due to prior radiation and the anticipated loss of approximately 80% of the lower lip after re-resection, reconstruction using an Abbe flap combined with bilateral advancement flaps was selected to minimize tension and introduce vascularized, non-radiated tissue. The patient healed well postoperatively, retained oral competence, and was satisfied with the cosmetic outcome. This case underscores the critical impact of prior radiation on reconstructive strategy and the need for tailored approaches to optimize both function and aesthetics.

Intended Audience:

This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.

Learning Objectives:

By the end of this activity, participants will be able to: 

1. Recognize the clinical presentation, diagnostic workup, and management options for lower lip squamous cell carcinoma, including the implications of perineural invasion.
2. Understand the reconstructive decision-making process for full-thickness lower lip defects, particularly in patients with a history of radiation therapy.
3. Describe the surgical technique, advantages, and limitations of the Abbe flap combined with bilateral advancement flaps in the reconstruction of radiated lip tissue.

Faculty

Joshua Vorstenbosch, MD, PhD, McGill University Health Centre (MUHC - Glen) - Royal Victoria Hospital

Evan Matros, MD, MMSc, MPH, Memorial Sloan Kettering Cancer Center

Rawan ElAbd, MD, MSc, McGill University Health Centre in Quebec, Canada

ABMS Core Competencies 

The following ABMS core competencies will be addressed:

• Patient Care
• Medical Knowledge
• Practice-based Learning and Improvement

Designation Statement

Not for AMA PRA Credit

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-into reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

NOT FOR AMA PRA Category 1 CreditTM: 

Media: Multimedia

Release Date:  07/11/2025

Expiration Date: 07/11/2028

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Not for AMA PRA Category 1 Credits ^TM

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