The Karapandzic flap can be used to reconstruct large lower lip defects.  In this procedure the nerves are preserved, which results in a functional reconstruction.

This flap is a rotation-advancement flap along the nasolabial folds.  Bilateral flaps can be used to reconstruct upto three quarters of a lower lip defect.

Furthermore it is possible to combine a Karapandzic flap on one side with a Schuchard flap on the other side.

In Karapandzic’s own words:

    “The flaps are paired.  The skin incision         parallels the lip margin at a distance equal to the depth of the defect. The branches of the facial artery going to the flaps are carefully dissected and preserved.  Similarly any sensory or motor nerve fibers encountered should be spared.  The mucous membrane is not divided apart from a small length at the ends to be approximated.”

Since the Karapandzic procedure adds no new lip tissue, it can result in microstoia.