Fig. 1. Intraoperative photograph of harvested ipsilateral flap demonstrating orientation of upper and lower lip paddles following 180° in-plane rotation. In this iteration, the nerve and vascular pedicle are reflected deep to the flap for coaptation with the ipsilateral nerve-to-masseter muscle and anastomosis with the facial vessels. The approximate location of the hilum (h) and course of the neurovascular pedicle (dotted lines: yellow—nerve-to-gracilis muscle, blue—venae comitans, red—artery) on the deep aspect of the flap is demonstrated, together with the continuation of the neurovascular pedicle (arrowhead) to the lower lip paddle.

Fig. 1. Intraoperative photograph of harvested ipsilateral flap demonstrating orientation of upper and lower lip paddles following 180° in-plane rotation. In this iteration, the nerve and vascular pedicle are reflected deep to the flap for coaptation with the ipsilateral nerve-to-masseter muscle and anastomosis with the facial vessels. The approximate location of the hilum (h) and course of the neurovascular pedicle (dotted lines: yellow—nerve-to-gracilis muscle, blue—venae comitans, red—artery) on the deep aspect of the flap is demonstrated, together with the continuation of the neurovascular pedicle (arrowhead) to the lower lip paddle.

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Fig. 1. Intraoperative photograph of harvested ipsilateral flap demonstrating orientation of upper and lower lip paddles following 180° in-plane rotation. In this iteration, the nerve and vascular pedicle are reflected deep to the flap for coaptation with the ipsilateral nerve-to-masseter muscle and anastomosis with the facial vessels. The approximate location of the hilum (h) and course of the neurovascular pedicle (dotted lines: yellow—nerve-to-gracilis muscle, blue—venae comitans, red—artery) on the deep aspect of the flap is demonstrated, together with the continuation of the neurovascular pedicle (arrowhead) to the lower lip paddle.