Lip Shave (Vermilionectomy)

Vermilionectomy or “lip shave” is a well-established procedure dating back to the nineteenth century for neoplastic disease of the lower lip. Today, it is reserved for management of actinic cheilitis or microinvasive carcinoma and can be combined with a lower lip wedge resection for more invasive lesions. It involves complete excision of the lower lip mucosa, followed by advancement of the labial mucosa over the defect and suturing to the labial skin. Although theoretically this appears to be a simple procedure of excising and elevating a single layer of tissue, the high aesthetic location, delicate tissue, and highly sensate region make this a technique-sensitive procedure for the surgeon and a challenging recovery for the patient. Nevertheless, vermilionectomy offers excellent control of the disease and provides a histologic assessment of the tissue.