Cleft - Ultimate Treatment
Unilateral lip-repair - The ULTIMATE Clinical pearls To achieve the best clinical outcome, various aspects have to be followed. Ignoring one or more of these aspects will lead to suboptimal aesthetic and functional results. The principles for the ultimate result in unilateral cleft lip repair are: 1. To recognize that a part of the lip congenitally is missing (measure the length on the non-cleft side from the natural philtrum edge, at the lip red-skin junction, and the junction of the lip commissure and compare this length at the cleft side) 2. The vertical length of the upper lip at the cleft side is always shorter. Therefore lengthening the lip on the cleft side by designing a triangle(s) is mandatory to achieve an ideal balance. In case this is ignored, a shorter lip at the cleft side will be immediately visible. 3. The upper lip horizontal length at the cleft side is always shorter, especially in wide clefts. Unfortunately, very little can be done to lengthen this part to achieve aesthetic balance. It is of utmost importance to achieve appropriate vertical (superior-inferior) lip dimensions at cleft side. Never compromise the vertical aspect in favour of the horizontal dimension. 4. The scar should be positioned as a mirror image of the philtrum edge to the non-cleft side, with the exception of the superior triangle.
Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...