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Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line.
Br J Plast Surg. 1998 Oct; 51(7):511-6.BJ

Abstract

The methods designed for the repair of a complete cleft lip should not be used to repair an incomplete cleft lip. This results too often in the postoperative drooping of the white lip on the affected side because in most incomplete cleft lips there is more tissue on the cleft side than in complete cleft lip. We present and discuss the refinements we made in our original technique for complete cleft lip in order to adapt it to incomplete cleft lip repair. The skin design at the white skin roll follows Cronin's method with an incision perpendicular to the vermilion border. The suture that pulls the edges of the angular incisions together pushes on the white skin roll caudally. This ensures that the peak of the Cupid's bow on the cleft side does not droop postoperatively. It also ensures that it does not take on an acute angle and that the vermilion border will be a continuous line without a break. We do not create a triangular flap at the vermilion border, but we raise a triangular flap at the alar base on the cleft side and advance it to the bottom of the columella. This creates the nostril sill and corrects the flared alar base. The resulting suture line is completely straight and runs along the philtral column. In this way, the postoperative elongation of the white lip on the cleft side can be prevented.

Authors+Show Affiliations

Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9924403

Citation

Nakajima, T, et al. "Primary Repair of an Incomplete Unilateral Cleft Lip: Avoiding an Elongated Lip and Achieving a Straight Suture Line." British Journal of Plastic Surgery, vol. 51, no. 7, 1998, pp. 511-6.
Nakajima T, Yoshimura Y, Yoneda K, et al. Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line. Br J Plast Surg. 1998;51(7):511-6.
Nakajima, T., Yoshimura, Y., Yoneda, K., & Nakanishi, Y. (1998). Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line. British Journal of Plastic Surgery, 51(7), 511-6.
Nakajima T, et al. Primary Repair of an Incomplete Unilateral Cleft Lip: Avoiding an Elongated Lip and Achieving a Straight Suture Line. Br J Plast Surg. 1998;51(7):511-6. PubMed PMID: 9924403.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line. AU - Nakajima,T, AU - Yoshimura,Y, AU - Yoneda,K, AU - Nakanishi,Y, PY - 1999/1/30/pubmed PY - 2000/4/25/medline PY - 1999/1/30/entrez SP - 511 EP - 6 JF - British journal of plastic surgery JO - Br J Plast Surg VL - 51 IS - 7 N2 - The methods designed for the repair of a complete cleft lip should not be used to repair an incomplete cleft lip. This results too often in the postoperative drooping of the white lip on the affected side because in most incomplete cleft lips there is more tissue on the cleft side than in complete cleft lip. We present and discuss the refinements we made in our original technique for complete cleft lip in order to adapt it to incomplete cleft lip repair. The skin design at the white skin roll follows Cronin's method with an incision perpendicular to the vermilion border. The suture that pulls the edges of the angular incisions together pushes on the white skin roll caudally. This ensures that the peak of the Cupid's bow on the cleft side does not droop postoperatively. It also ensures that it does not take on an acute angle and that the vermilion border will be a continuous line without a break. We do not create a triangular flap at the vermilion border, but we raise a triangular flap at the alar base on the cleft side and advance it to the bottom of the columella. This creates the nostril sill and corrects the flared alar base. The resulting suture line is completely straight and runs along the philtral column. In this way, the postoperative elongation of the white lip on the cleft side can be prevented. SN - 0007-1226 UR - https://www.unboundmedicine.com/medline/citation/9924403/Primary_repair_of_an_incomplete_unilateral_cleft_lip:_avoiding_an_elongated_lip_and_achieving_a_straight_suture_line_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007122697901818 DB - PRIME DP - Unbound Medicine ER -