BACKGROUND: Through-and-through cheek defects involving both lips and the oral commissure may result from cancer ablation. Reconstructive procedures for repairing the defect usually lead to oral incontinence, drooling, and difficulties with speech and oral access, and require further revision in a second-stage operation. METHODS: An innovative, free double-paddle peroneal chimeric flap is used to achieve one-stage reconstruction for through-and-through cheek defects involving both lips and the oral commissure. RESULTS: From January 1996 to December 2012, a total of 55 patients underwent reconstructions of through-and-through cheek defects involving both lips and the oral commissure with free double-paddle peroneal chimeric flaps after their oral cancer resection. Both the functional and esthetic results were excellent in most of the patients. CONCLUSION: Free double-paddle peroneal chimeric flap with this novel flap design and inset method can produce functionally and aesthetically pleasing lips, vermilion borders, and oral commissure in one-stage reconstruction after oral cancer ablation.
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