"Take these three items, some WD-40, a vise grip, and a roll of duct tape. Any man worth his salt can fix almost any problem with this stuff alone"  Clint Eastwood in Gran Torino

“All the king's horses and all the king's men-Couldn't put Humpty together again:”  Nursery rhyme 

This patient came into the operating room in November, 2010 with a Band-aid across his upper lip. I didn’t realize that the Band-aid was practically holding his face together. He had a tumor of the lip that had been present for years. The tumor was previously removed but recurred. The tumor involved the entire upper lip and destroyed the central portion. There a separate lesion was on his nose.

I knew this would be a challenging problem. I wanted to make sure this would be the last surgery he required. 

The surgery required removal of the entire upper lip. After you remove someone’s entire lip, you realize there’s no going back. We then reconstructed the mouth with a Gillies type Fan Flap. We cauterized the lesion on his nose.

I was so happy when he came back to see me three months later. The result was not perfect. His mouth was smaller, of course, but he could open it wide and had good lip function. His speech was barely changed.

This neoplasm was a basal cell carcinoma. He refused radiation but has no recurrence to date.