What is the procedure for lower lip reconstruction using the Abbe (Arterial-Based Bilateral Estlander) flap?

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Last updated: March 22, 2025View editorial policy

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From the Research

The Abbe flap is a highly effective technique for lower lip reconstruction, particularly for defects involving the central portion of the lower lip, and involves transferring tissue from the upper lip to reconstruct the lower lip while maintaining both function and aesthetics, as supported by the most recent and highest quality study 1. The procedure requires a two-stage approach: first, a full-thickness wedge of tissue from the upper lip (including skin, muscle, and mucosa) is transferred to the lower lip defect while maintaining a pedicle attachment to preserve blood supply through the labial artery. The pedicle is divided approximately 2-3 weeks later during a second procedure once neovascularization has occurred. This reconstruction method is particularly valuable because it provides tissue with similar color, texture, and vermilion characteristics, and preserves the orbicularis oris muscle function, which is essential for oral competence, speech, and facial expression. Some key points to consider when performing the Abbe flap procedure include:

  • The importance of maintaining a pedicle attachment to preserve blood supply through the labial artery 2
  • The need for a two-stage approach to allow for neovascularization to occur before pedicle division 3
  • The potential for combining the Abbe flap with other techniques, such as the Karapandzic flap, to achieve optimal results for larger defects 1
  • The importance of careful postoperative care, including a soft diet, careful oral hygiene, and protection of the pedicle until division, to minimize the risk of complications such as flap necrosis or microstomia 4 Overall, the Abbe flap is a reliable and effective technique for lower lip reconstruction, and can be tailored to meet the individual needs of each patient to achieve optimal functional and aesthetic results.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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