CPT® Code 40525

A full thickness excision of the lip involves the surgical removal of tissue from the lip, which is then reconstructed using a local flap technique. This procedure is commonly referred to as an Estlander or fan flap, and it may also involve a cross lip flap, known as the Abbe-Estlander flap. The process begins with the careful marking of incision lines on the lip using a surgical marking pen, ensuring that if the excision is performed to remove a lesion, there is a margin of healthy tissue included around the lesion to promote healing and reduce the risk of recurrence. Local anesthesia, often combined with epinephrine, is administered to minimize discomfort and control bleeding during the procedure. The surgical technique involves a wedge resection, where the lip is incised perpendicularly through both the cutaneous lip and the vermilion, converging at the white part of the lip to remove a wedge-shaped section of tissue. Following the excision, the defect is reconstructed using a local flap, which includes both cutaneous lip and vermilion tissue, and is advanced over the defect to restore the lip's appearance and function. In some cases, a cross lip flap may be utilized, which is a more complex two-stage procedure involving the transfer of tissue from one lip to the other, ensuring adequate blood supply through the labial artery. This comprehensive approach to lip reconstruction aims to achieve optimal aesthetic and functional outcomes for the patient.