Lip amputation can lead to detrimental consequences on aesthetics and function. Primary reconstruction is always preferred over secondary reconstruction. We present a successful lip replantation performed at our unit.
60 year old male presented to the emergency department at Middlemore hospital, Auckland, following an right upper lip amputation from a dog bite. The family afghan hound got a fright and bit the patient’s right upper lip. The amputated right upper lip was found in the chest hair of the afghan hound, and was brought in with a three hour warm ischaemic time. There were no other injuries. He was fit and healthy, and was a non-smoker. There was a full thickness defect of the right upper lip with an estimated surface area of 6cm2. One arterial anastomosis was performed to superior labial artery medially. There were no obvious veins for anastomosis. Leech therapy was commenced four hours post-op and continued for five days. The patient was discharged on day seven with good perfusion of the replanted lip and no venous congestion. At four months post-op review, he had good return of function and an excellent cosmetic outcome.
Replantation of amputated lip can be successful and should be attempted in appropriate circumstances.