Part of the lip is missing
A notch or step on the lip is visible, the lip is shorter on one side.
CONDITION / FACE
Defects and deformations of the lips.
Lip defects are the loss of part of the lip after an injury, bite, or tumor removal, and deformities are scars, asymmetry, or a narrowed mouth that remain after healing. The lip is restored with an operation - reconstructive cheiloplasty.
CONCEPTUAL VISUALIZATION- What it is
- Loss of a part of the lip or its deformation after an injury, bite or removal of a tumor.
- Most often
- Among the acquired causes of lip defects, the most common is the removal of a malignant tumor.
- The goal
- So that the mouth closed, the lip moved and felt, and the lip lines were in place.
- Who treats it
- Plastic surgeon; the tumor is treated by an oncologist.
01 / WHAT IS ITWhat is
What is
lip defects
The lip consists of three layers: skin, muscle and mucous membrane. It is needed to speak, eat and drink, feel touch, and it is very visible on the face. Therefore, even a small defect is noticeable and can interfere.
A defect is when part of the lip is missing: it was removed with a tumor or lost due to an injury or bite. Deformation — when there is enough tissue, but the lip has healed incorrectly: the scar tightens it, the border of the red border has shifted, the mouth has become smaller.
The goal of restoration is that the mouth closes securely and food and saliva do not flow in, the lip feels and moves, and the visible lines - the border of the lip and skin, the corners of the mouth - are in their place.
This page is dedicated to lip repair for any reason. About the tumor itself - on the page "Cancer of the lips".
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow they manifest
How they manifest
lip defects
Some are bothered by the appearance, others by the fact that the mouth does not close well or the lip does not feel. Often, both.
The scar tightens the lip
The lip is pulled up or down, everted, a thick or retracted scar is visible on it.
Scars after facial injuriesThe border of the lip is shifted
The border between the red border and the skin does not coincide - the step is visible even from a distance.
The mouth does not close
Food, liquid or saliva flows, it is more difficult to pronounce individual sounds.
The mouth became smaller
It is difficult to open your mouth wide, eat or brush your teeth.
MicrostomeNumbness
Part of the lip does not feel touch, heat or cold.
03 / REASONSWhy do they arise?
Why do they arise?
lip defects
The reason depends on when and how the lip is restored: after an injury — after healing, after a tumor — often in the same operation.
Tumor removal
The most common acquired cause. About 25% of oral cavity cancers affect the lips, and they are treated primarily by removal.
Lip cancerBites
When a dog bites the face, the lips, cheeks and nose are most often affected. After a human bite, in addition to treating the wound, tests for hepatitis B and C and HIV can be offered.
Animal bites on the faceLacerations
Falls, blows, road accidents. It is most difficult to treat wounds that affect the border of the red border or more than a quarter of the lip.
Unsuccessful healing
The wound has spread, healed with a rough scar or without exact alignment of the edges.
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
A long-standing defect or scar on the lip is a planned situation, it does not need urgent help. A fresh wound is another matter: the lip is stitched exactly along the border, so the wound should be shown to the doctor on the same day.
103 or immediately to the reception department, if:
- the lip wound is large or deep;
- the bleeding does not stop;
- part of the lip is torn off - wrap it in a clean tissue, put it in a bag, cover the bag with ice and take it with you.
Do not delay:
On the same day: any lip bite that breaks the skin - animal or human: wound dressing and vaccination decisions are required. On the same day - and if the wound dissects the border of the red border, the wound is hot, swollen, oozes fluid or smells unpleasant, has a fever or is freezing. In the coming weeks: an ulcer on the lip that does not heal for more than 3 weeks, a lump on the lip or neck - see a doctor: these signs often have other causes, but it is worth checking. Planned: old defects, scars, asymmetry, narrowed mouth.
05 / DIAGNOSTICSAs defined,
As defined,
what to restore
- Questioning
What happened and when, what operations have already taken place; after the tumor - histology conclusion.
- Review
The surgeon assesses how much of the lip is lost, what layers are affected—skin, muscle, mucosa—and whether there is enough nearby tissue.
- Function
Does the mouth close, how does the lip move and feel how wide the mouth opens.
- Plan
The method is selected according to the size and location of the defect, the condition of the tissues, the patient's age and wishes.
06 / TREATMENTHow to restore
How to restore
the lip
There is no universal method: there are few qualitative comparative studies, so the surgeon chooses the method based on the size, location and depth of the defect. The less tissue is lost, the easier the operation.
01
Small defects
Up to a third of the lip.
- Stitching
- If less than 30% of the lip is missing, the edges are usually reduced and sutured - a direct wound or an excised wedge.
- The result
- In a study of 336 cases of early lip cancer treated with excision or internal radiation (brachytherapy), quality of life, function and facial appearance after treatment were rated as good.
- How common
- Among 615 lip reconstructions after cancer removal, most defects were closed in this way.
02
Average defects
From one third to two thirds of the lip.
- Lip flaps
- The tissue is taken from the second lip on the feeding vessel or moved around the mouth from the same lip.
- Flaps from the cheek
- When there is not enough lip tissue, the lip is formed from the adjacent cheek tissue.
- Risks
- According to a systematic review of 18 studies, complications after local flaps — an average of 8%: wound separation, numbness, narrowing of the mouth, drooling.
- What affects
- In a study of 108 patients after removal of lip cancer, the risk of early complications was higher if the defect was 20 mm or more or was full-thickness of the lip.
03
Major and complete defects
- Free flaps
- For large defects, microsurgical reconstruction is recommended: tissues from the forearm are transplanted, stitching the vessels together under a microscope.
- Why not local
- If the entire lip is restored with only local flaps, the mouth often becomes too narrow.
- What to expect
- After major reconstructions, some impairment of function is likely to remain, but new techniques are better at restoring sensation and movement.
04
Scars and deformations
After healing.
- Scars
- A rough scar is cut out, the edge of the border is drawn anew.
- Narrowed mouth
- If the mouth has narrowed after healing, it is treated separately - more details on the "Microstoma" page.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Defects and deformations of the lips are treated at the Institute of Surgery of Dr. Valikhnovskyi in the "New Face" direction. If the defect remains after the removal of the cancer, the tumor is treated by an oncologist, and the clinic is responsible for removing and restoring the lip.
CLINIC SERVICE
A new face
Form, symmetry, facial expressions and functions after injuries, wounds, burns, removal of tumors and congenital changes.
View service
What we do for this condition
- Local patches — nasolabial and cervicofacial flaps — tissues closest in color and texture.
- Perforating facial flaps — a flap of skin on a thin vessel closes the defect without gross tension and does not distort the line of the mouth.
- Radial forearm flap — a thin and flexible flap used to restore the lips, cheeks and mucous membrane of the mouth.
- Reconstruction immediately — after removal of the tumor, the lip is often restored in the same operation, if the edges of the incision are clean; otherwise - after histology.
- Excision of scars — a scar that tightens the lip is cut out and covered with local fabrics.
- Lipofilling — own fat evens out the contour and helps make scars softer.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSubmit a photo of the face straight on and from the side, with the mouth closed and open, and extracts, if applicable.
- ConsultationExamination of the lip, evaluation of mouth closure, movements and sensitivity.
- PlanThe method and number of stages depends on the size and location of the defect.
- SurgerySuturing, local or free flap, excision of the scar - sometimes in several stages.
- RecoverySwelling of the lip passes in weeks, scars mature in months; the doctor will explain the care.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
Is it possible to restore a lip if a part was torn off during a bite?
Yes. If the torn part is preserved, it is taken with them to the hospital. If not, the lip is restored with own tissues - from the other lip, cheek or other parts of the body.
When can a scar on the lip be corrected after an injury?
Usually after the scar matures, when it becomes paler and softer. Earlier - if the scar tightens the lip and prevents opening the mouth.
Is the lip restored in the same operation as the tumor removal?
Often yes, if the cut edges are clean. If histology is required, the lip is restored after it.
Is it possible to operate in old age or on blood thinners?
In a study of 615 patients, the rate of complications did not differ in people older than 75 years, smokers, and those taking blood-thinning medications. What is right for you, the doctor will decide after the examination.
Will the mouth become smaller after surgery?
Maybe, especially if most of the lip is restored with local tissues. In a study of 102 patients after a circular flap, the mouth narrowed in 15.7%. The narrowing of the mouth is treated separately - about it on the "Microstoma" page.
Will the lip feel?
Numbness is one of the most frequent complications after local flaps. How much sensitivity is retained depends on the size of the defect and the method.
The ulcer on the lip does not heal. Is it dangerous?
If the ulcer does not heal for more than 3 weeks, see a doctor. Such signs often have other causes, but it is worth checking.
Sources
16 sources · systematic reviews, reviews, cohorts and NHSshowCollapse
- Lip ReconstructionSeminars in Plastic Surgery, 2024doi:10.1055/s-0044-1792107 ↗
- Simplifying Lip Reconstruction: An Algorithmic ApproachSeminars in Plastic Surgery, 2018doi:10.1055/s-0038-1645882 ↗
- Lip Reconstruction after Tumor AblationWorld Journal of Plastic Surgery, 2016pubmed.ncbi.nlm.nih.gov/27308236 ↗
- Recent advances in lip reconstructionCurrent Opinion in Otolaryngology & Head and Neck Surgery, 2019doi:10.1097/MOO.0000000000000531 ↗
- Total lower lip reconstruction: a review of recent advancesCurrent Opinion in Otolaryngology & Head and Neck Surgery, 2023doi:10.1097/MOO.0000000000000926 ↗
- Composite pronator quadratus: radial forearm free flap in functional lip reconstructionANZ Journal of Surgery, 2019doi:10.1111/ans.14980 ↗
- Lip Reconstruction after Mohs Cancer Excision: Lessons Learned from 615 Consecutive CasesPlastic and Reconstructive Surgery, 2020doi:10.1097/PRS.0000000000006509 ↗
- Complications Following Local-Flap Lip Reconstruction After Tumor Removal: A Systematic ReviewCureus, 2025doi:10.7759/cureus.85155 ↗
- Complications Following Karapandzic Flap Reconstruction of the Lip: A Retrospective Cohort StudyMedicina (Kaunas), 2025doi:10.3390/medicina62010012 ↗
- Lip carcinoma: clinical presentation, surgical treatment, and outcome: a series of 108 cases from DenmarkJournal of Plastic Surgery and Hand Surgery, 2017doi:10.1080/2000656X.2016.1270215 ↗
- Long-term outcomes, quality of life, and costs of treatment modalities for T1-T2 lip carcinomasOral Diseases, 2024doi:10.1111/odi.14723 ↗
- Reconstruction of Perioral Defects After Mohs Micrographic Surgery or Excision: A Systematic Review of the LiteratureDermatologic Surgery, 2021doi:10.1097/DSS.0000000000002810 ↗
- Lip Laceration and Vermilion Border RepairAdvanced Emergency Nursing Journal, 2021doi:10.1097/TME.0000000000000356 ↗
- Dog bite injuries to the face: A narrative review of the literatureWorld Journal of Otorhinolaryngology – Head and Neck Surgery, 2022doi:10.1016/j.wjorl.2020.11.001 ↗
- Animal and human bitesNHS, 2025nhs.uk/conditions/animal-and-human-bites ↗
- Symptoms of mouth cancerNHS, 2023nhs.uk/conditions/mouth-cancer/symptoms ↗
The figures on the page are from these sources.
The lip has changed
after an injury or surgery?
Send a photo of your face with your mouth closed and open. The doctor will tell you how to restore the lip.