An ulcer that does not heal
The wound on the lip does not heal for more than 3 weeks.
CONDITION / FACE
Lip cancer: removal and reconstruction.
Lip cancer is a malignant tumor of the red border of the lip, most often the lower lip. It is noticeable early, and at an early stage it is well treated: the tumor is removed, and the lip is restored, often in the same operation.
CONCEPTUAL VISUALIZATION- What it is
- Malignant tumor of the lip; most often - squamous cell cancer of the lower lip.
- How common
- In the United States, up to 2.5 cases of squamous cell carcinoma of the lip per 100,000 people.
- Forecast
- One of the most curable head and neck cancers because it is detected early.
- Who treats it
- The oncologist determines the plan; the surgeon removes the tumor and restores the lip.
01 / WHAT IS ITWhat is
What is
lip cancer
Lip cancer is a malignant tumor that grows from the red border or skin of the lip. Most often, it is squamous cell cancer, less often - basal cell carcinoma. In a series of 108 patients of one plastic surgery clinic, 65% had squamous cell carcinoma, 33% had basal cell carcinoma; half of the patients were 72 years or older.
Squamous cell cancer of the lip develops gradually: first, the cells of the mucous membrane change (doctors say "dysplasia"), and it is often preceded by precancerous changes. Because of this, any ulcer on the lip that does not heal is advised to be checked with a biopsy.
The lip is visible, so cancer is detected early. Therefore, lip cancer is one of the most curable head and neck cancers if it is found at an early stage. In advanced cases, treatment by several specialists is required.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSHow
How
lip cancer presents.
These signs often occur in other, non-cancerous conditions. But if they persist for more than 3 weeks, they should be shown to a doctor.
Sealing on the lip
A lump or hardening on the lip that does not go away.
A red or white spot
The area of the lip has changed color. Biopsies sometimes show cancer even where to the eye it looks like cheilitis—inflammation of the lip from the sun.
Precancerous diseases of the lipsA knot on the neck
An enlarged lymph node in the neck may mean that the cancer has spread.
Neoplasm of the neck03 / REASONSWhy does it occur?
Why does it occur?
lip cancer
The main reason is the sun; the lower lip is most often affected. Other factors add to the risk.
the sun
UV radiation accumulated over the years is the main cause of lip skin cancer. Fair-skinned men over 40 who spend a lot of time in the sun get sick more often.
Precancerous changes
Lip cancer is often preceded by precancerous lesions, in particular actinic cheilitis. In the archive of biopsies of one laboratory, eight lesions that were thought to be cheilitis on examination turned out to be lip cancer under the microscope.
Precancerous diseasesSmoking and alcohol
Tobacco and alcohol increase the risk of lip and oral cancer.
Depressed immunity
After organ transplantation, the risk of invasive lip cancer was 15.3 times higher than in the general population (261,500 recipients).
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Cancer of the lip usually does not require emergency care, but you should not postpone the examination: the earlier it is found, the easier it is to treat.
103 immediately if:
- bleeding from an ulcer or wound on the lip does not stop;
- the blood gushes, bright red, hard to stop.
See a doctor without delay if:
On the same day: the wound after surgery on the lip is swollen, reddened, hurts more and more, pus flows from it or the temperature rises. Urgently, without waiting for a scheduled appointment, to a dentist or maxillofacial surgeon: an ulcer on the lip that does not heal for more than 3 weeks, a lump appears, a red or white spot on the lip, or a lump on the neck that does not go away.
05 / DIAGNOSTICSAs confirmed
As confirmed
diagnosis
- Review
The doctor examines the lip and oral cavity, feels the neck and jaw for enlarged lymph nodes.
- Biopsy
A piece of tissue is examined under a microscope. This is the only way to distinguish cancer from precancerous changes.
- stage
The stage is determined by examination and images: the size of the tumor, whether the lymph nodes are affected.
- Neck lymph nodes
High-risk, early-stage patients may need a biopsy of the sentinel lymph node—the first node where the cancer may have spread.
06 / TREATMENTHow we treat
How we treat
lip cancer
The main method is surgery: the tumor is removed together with a supply of healthy tissue. Early lip cancer can be treated equally effectively with surgery or radiation therapy. The plan is drawn up by the oncologist together with the surgeon.
01
Tumor removal
The goal is clean edges: in the removed tissue, the tumor does not reach the incision.
- Excision
- The tumor is excised with a reserve of healthy tissue; British guidance advises around 1cm where important structures allow. The removed must be examined under a microscope.
- Radiation therapy
- An alternative to surgery at an early stage. In a study of 38 patients after brachytherapy — radiation from inside the tumor — local recurrence was 5.6%, 19% had cancer in the lymph nodes, and all had mucosal inflammation.
- Neck lymph nodes
- In sentinel lymph node biopsies, hidden metastases were found in approximately 10% of cases. If the cancer is already in the lymph nodes, the neck nodes are removed and radiation therapy is added — this is done by an oncologist.
02
Restoration of the lip
The method depends on which part of the lip is removed.
- Small defect
- Small defects are often closed with a simple suture or a wedge-shaped excision: in a cohort of 615 patients, the vast majority of defects were closed this way after the cancer was removed.
- Average defect
- The lip is restored with local flaps — tissues from nearby areas, preserving the closure of the lips.
- Big defect
- If more than half of the lip is removed, it is more likely that the lips will not close and the mouth will be narrowed (microstoma). Then the reconstruction is planned especially carefully.
03
Outcome and risks
- Complications
- In a review of 18 studies of local flaps, complications were on average in 8%: wound separation, numbness, narrowing of the mouth, drooling.
- Healing
- In a series of 108 patients, 32% had healing problems, but most were mild and did not require treatment.
- Smoking
- In a cohort of 221 patients, smoking was associated with complications after lip reconstruction and with more frequent mouth narrowing.
- Forecast
- For skin cancer of the lip, the five-year disease-related survival rate in a large registry is 94.7%. For late stages of lip and mouth cancer, the prognosis is worse.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
Lip cancer is treated in the "New face" direction at Dr. Valikhnovskyi's Institute of Surgery. The clinic is responsible for its part — lip tumor removal and lip restoration. The stage, treatment of neck lymph nodes, radiation and drug therapy is determined by the oncologist, and the surgical plan is coordinated with him.
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
- Removal with reconstruction in one operation — if the edges of the cut are clean, the lip is restored immediately; otherwise - after histology.
- Local patches — small and medium defects are covered with facial tissues: they are the closest in color and texture.
- Perforating facial flaps — make it possible to close the wound without rough tension and distortion of the mouth line.
- Radial forearm flap — a thin flap from the forearm, which is used to restore the lips and mucous membrane when there is not enough facial tissue.
- Scar correction and lipofilling — scars tightening the lip, cutting out; own fat helps to smooth the contour.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSend a photo of the lip and the results of the biopsy, if any - the doctor will assess the situation beforehand.
- ConsultationLip and neck examination; if a biopsy has not yet been done - an examination plan.
- PlanHow much tissue needs to be removed and how to restore the lip is agreed with the oncologist.
- SurgeryTumor removal and lip reconstruction, often in one go.
- RecoveryCare of the wound, control of histology and regular examinations by an oncologist.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
How to distinguish lip cancer from an ordinary sore?
By eye - no way. If an ulcer or spot on the lip does not heal for more than 3 weeks, it is shown to the doctor; only a biopsy gives an exact answer.
Is lip cancer curable?
Lip cancer is one of the most curable head and neck cancers if found early. For later stages, the prognosis is worse.
Which is better — surgery or radiation?
Early lip cancer can be treated equally effectively with surgery or radiation therapy. The choice is made together with the oncologist.
Will the lip change after surgery?
Small defects are usually closed with a simple suture. If a large part of the lip is removed, narrowing of the mouth and non-closing of the lips are more common, so the reconstruction is planned in such a way as to preserve the closing of the lips.
Should the neck lymph nodes be removed?
Not always. In sentinel lymph node biopsies, hidden metastases were found in approximately 10% of cases; the need for a biopsy or removal of nodes is determined by an oncologist.
Can lip cancer come back?
Maybe In a series of 108 patients, local recurrence of squamous cell carcinoma was 1 in 70, lymph node metastases in 7%. Therefore, regular examinations are required after treatment.
Can the risk be reduced?
The main risk factors are the sun, smoking and suppressed immunity. Precancerous changes of the lips should be shown to the doctor in time.
Sources
17 sources · reviews, guidelines and researchshowCollapse
- Oral cavity and lip cancer: United Kingdom National Multidisciplinary GuidelinesThe Journal of Laryngology and Otology, 2016doi:10.1017/S0022215116000499 ↗
- AHNS Series - Do you know your guidelines? Lip cancerHead & Neck, 2017doi:10.1002/hed.24817 ↗
- Lip and Oral Cavity Squamous Cell CarcinomaHematology/Oncology Clinics of North America, 2021doi:10.1016/j.hoc.2021.05.003 ↗
- Rate of occult metastasis in lip squamous cell carcinoma: A systematic review and meta-analysisHead & Neck, 2024doi:10.1002/hed.27747 ↗
- Primary cN0 lip squamous cell carcinoma and elective neck dissection: Systematic review and meta-analysisHead & Neck, 2015doi:10.1002/hed.23772 ↗
- Complications Following Local-Flap Lip Reconstruction After Tumor Removal: A Systematic ReviewCureus, 2025doi:10.7759/cureus.85155 ↗
- Lip ReconstructionSeminars in Plastic Surgery, 2024doi:10.1055/s-0044-1792107 ↗
- Lip Reconstruction Following Cancer ResectionHead & Neck, 2026doi:10.1002/hed.70020 ↗
- Lip Reconstruction after Mohs Cancer Excision: Lessons Learned from 615 Consecutive CasesPlastic and Reconstructive Surgery, 2020doi:10.1097/PRS.0000000000006509 ↗
- Actinic cheilitis and lip squamous cell carcinoma: Literature review and new data from BrazilJournal of Clinical and Experimental Dentistry, 2019doi:10.4317/jced.55133 ↗
- Cutaneous squamous cell carcinoma of the lip: A population-based analysisThe Laryngoscope, 2018doi:10.1002/lary.26704 ↗
- Risk of lip cancer after solid organ transplantation in the United StatesAmerican Journal of Transplantation, 2019doi:10.1111/ajt.15052 ↗
- 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 ↗
- Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life AnalysisCancers, 2021doi:10.3390/cancers13061387 ↗
- Symptoms of mouth cancerNHS, 2023nhs.uk/conditions/mouth-cancer/symptoms ↗
- Treatment for mouth cancerNHS, 2023nhs.uk/conditions/mouth-cancer/treatment ↗
- Cuts and grazesNHS, 2026nhs.uk/conditions/cuts-and-grazes ↗
The figures on the page are from these sources.
A wound on the lip
doesn't heal?
Send a photo of the lip and the results of the examinations. The doctor will tell you what to do next and how to restore the lip after removing the tumor.