Mumbai/Kolkata, July 18: For years, an 18-year-old girl from Sreerampore, Hooghly, lived behind a mask, avoiding social interactions and struggling with everyday activities like eating and speaking due to a rare vascular malformation that had gradually engulfed almost her entire lower lip. What began as a small lesion eventually grew into a massive 7 cm × 7 cm blood vessel tumour, making it impossible for her to close her mouth properly, causing constant drooling and severely affecting her confidence and quality of life. In a highly complex reconstructive surgery, Dr. Akhilesh Kumar Agarwal, Consultant – Plastic Surgeon at Manipal Hospital Mukundapur, successfully removed the tumour and reconstructed her lower lip, restoring both its appearance and function, enabling the young girl to smile, eat, and step out with renewed confidence.
The patient had been living with the condition for nearly four years and had consulted several hospitals before reaching Manipal Hospital Mukundapur. An MRI scan confirmed that she had a large vascular malformation, a rare condition in which blood vessels develop abnormally covering almost her entire lower lip. Since the growth was made up of abnormal blood vessels, the surgery was highly challenging because of the risk of heavy bleeding. The surgical team carefully removed the entire vascular malformation along with most of the affected lower lip. However, removing the growth was only the first step. The bigger challenge was rebuilding the lower lip so that the patient could eat, speak, and close her mouth normally while also restoring its natural appearance. To reconstruct the lip, surgeons used tissue and blood vessels from the patients forearm to create the inner lining of the lip. A tendon from the forearm was used to provide support, helping her keep her mouth closed and prevent drooling. The pink part of the lip was then recreated using tissue taken from the inside of the cheek. This advanced reconstruction restored both the appearance and normal function of the lower lip.
Commenting on the case, Dr. Akhilesh Kumar Agarwal, Consultant – Plastic Surgeon, Manipal Hospital Mukundapur, said, “As reconstructive plastic surgeons, our objective extends far beyond removing a disease, we strive to restore normalcy, dignity, and confidence in a persons life. This was an extremely challenging case because the vascular malformation involved almost the entire lower lip and carried a significant risk of bleeding during surgery. After complete tumour excision, the real challenge was recreating a lip that was not only aesthetically acceptable but also functionally competent. By combining microsurgical free tissue transfer with tendon suspension and local flap reconstruction, we were able to restore both form and function. Seeing her smile, eat comfortably, and regain the confidence to step out without wearing a mask is the most rewarding outcome we could hope for.”
The patient remained admitted for nearly a week following the surgery and recovered well. During follow-up, she was able to eat normally, retain food and liquids without drooling, and gradually resume her daily activities. While a few minor corrective procedures may still be required as part of her long-term rehabilitation, her overall recovery has been highly encouraging.
Sharing the familys journey, the girls father, a resident of Sreerampore in Hooghly district who runs a local shop, said, “My daughter had this tumour from a very young age, and it kept growing with time. We visited several hospitals over the years, but we were either advised to wait until she grew older or were told that the surgery would be too difficult. Watching her struggle every day and lose confidence was heartbreaking. We are grateful to Dr. Akhilesh Agarwal and the entire team at Manipal Hospital Mukundapur for giving her a new beginning. Today, she can eat comfortably, smile again, and slowly return to a normal life. We cannot thank them enough for what they have done for our daughter.”