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Unilateral complete cleft lip repair: orthotopic positioning of skin flaps.
Br J Plast Surg 2005; 58(2):147-52BJ

Abstract

The ideally repaired cleft lip should provide a symmetrical Cupid's bow, philtrum, and minimal scar. In the appearance of the upper lip, the philtrum plays a key role. The most popular method for unilateral cleft lip repair is the rotation-advancement technique introduced by Millard. This technique requires the rotation of the noncleft side flap in unilateral cleft lip. As the vertical discrepancy between the peaks of Cupid's bow is increased, the scarring becomes more evident. Also, where it crosses the philtral column in the oblique extension of the upper lip, it becomes apparent for the eye to notice. Thus, many surgeons have tried to modify this technique to improve the symmetry of the philtral columns. The philtral dimple is composed of centrally located thin dense subcutaneous tissue bordered by thick loose subcutaneous tissue producing the philtral columns laterally. The aim of this surgical modification is to form a more natural looking philtrum using its original anatomical structure. The tissue defect after rotation of the noncleft side flap is filled with the C flap, not the advancement skin flap from the cleft side. The C flap helps to form the upper philtral column into a more straight appearance. The skin flaps of the cleft side and noncleft side are placed either side of the philtral column, and the skin flap from the columella is not used for the repair of the philtrum. Twenty-five patients with unilateral complete cleft lip were repaired using this technique from 1996 to 1999. Adequate alignment of the Cupid's bow and symmetric philtral appearance were obtainable.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, SongPaGu, Seoul 138-736, South Korea. kskoh@amc.seoul.krNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15710106

Citation

Koh, Kyung Suck, and Joon Pio Hong. "Unilateral Complete Cleft Lip Repair: Orthotopic Positioning of Skin Flaps." British Journal of Plastic Surgery, vol. 58, no. 2, 2005, pp. 147-52.
Koh KS, Hong JP. Unilateral complete cleft lip repair: orthotopic positioning of skin flaps. Br J Plast Surg. 2005;58(2):147-52.
Koh, K. S., & Hong, J. P. (2005). Unilateral complete cleft lip repair: orthotopic positioning of skin flaps. British Journal of Plastic Surgery, 58(2), pp. 147-52.
Koh KS, Hong JP. Unilateral Complete Cleft Lip Repair: Orthotopic Positioning of Skin Flaps. Br J Plast Surg. 2005;58(2):147-52. PubMed PMID: 15710106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Unilateral complete cleft lip repair: orthotopic positioning of skin flaps. AU - Koh,Kyung Suck, AU - Hong,Joon Pio, PY - 2004/05/02/received PY - 2004/10/15/accepted PY - 2005/2/16/pubmed PY - 2005/5/20/medline PY - 2005/2/16/entrez SP - 147 EP - 52 JF - British journal of plastic surgery JO - Br J Plast Surg VL - 58 IS - 2 N2 - The ideally repaired cleft lip should provide a symmetrical Cupid's bow, philtrum, and minimal scar. In the appearance of the upper lip, the philtrum plays a key role. The most popular method for unilateral cleft lip repair is the rotation-advancement technique introduced by Millard. This technique requires the rotation of the noncleft side flap in unilateral cleft lip. As the vertical discrepancy between the peaks of Cupid's bow is increased, the scarring becomes more evident. Also, where it crosses the philtral column in the oblique extension of the upper lip, it becomes apparent for the eye to notice. Thus, many surgeons have tried to modify this technique to improve the symmetry of the philtral columns. The philtral dimple is composed of centrally located thin dense subcutaneous tissue bordered by thick loose subcutaneous tissue producing the philtral columns laterally. The aim of this surgical modification is to form a more natural looking philtrum using its original anatomical structure. The tissue defect after rotation of the noncleft side flap is filled with the C flap, not the advancement skin flap from the cleft side. The C flap helps to form the upper philtral column into a more straight appearance. The skin flaps of the cleft side and noncleft side are placed either side of the philtral column, and the skin flap from the columella is not used for the repair of the philtrum. Twenty-five patients with unilateral complete cleft lip were repaired using this technique from 1996 to 1999. Adequate alignment of the Cupid's bow and symmetric philtral appearance were obtainable. SN - 0007-1226 UR - https://www.unboundmedicine.com/medline/citation/15710106/Unilateral_complete_cleft_lip_repair:_orthotopic_positioning_of_skin_flaps_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-1226(04)00284-X DB - PRIME DP - Unbound Medicine ER -