Photographic Analysis of Lip Repair in the Bilateral complete cleft lip and palate.

Bang, Chee Young; Kim, Suk Wha

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(2):222-228.
Published online March 1, 1999.

Photographic Analysis of Lip Repair in the Bilateral complete cleft lip and palate.

Chee Young Bang, Suk Wha Kim

Abstract

Characteristic residual deformities are thought to be unavoidable in most bilateral complete cleft lip and palate patients. Newly-adopted designs and modified surgical strategies were applied to 40 consecutive patients of bilateral complete cleft lip and palate and some characteristic deformities could be overcome. The future midline on the lateral lip segment was marked on the white roll of thickest vermilion and the alar base was transposed medially without circumalar incision. The prolabial width was reduced to 4-5 mm in consideration of further widening. To evaluate the outcome of bilateral cleft lip repair, 15 patients with adequate photographic records were assessed separately and overall by a panel of judges. Gross facial attractiveness of the visual analog recording scale correlated well with the cleft impairment scale. Full-bodied vermilion with tubercle was achieved and upper lip tightening and tower lip pouting could be avoided. Adequate philtral width was maintained over a 3-year follow-up. Nasal tip projection and proper alar position could be accomplished without circumalar incision. Cleft impairment scale showed impaired characteristics os short columella, no nostril sill, transverse nostril axis, flat and undimpled philtrum, convex-profiled upper lip and a downward drawn nose. Columellar length and nostril axis were expected to improve with growth and development. Absence of the philtral dimple and convex-profilled upper lip still remain to be solved. A reliable, easy to perform, and inexpensive evaluation protocol was provided for bilateral cleft lip repair and selected surgical procedures and postoperative outcomes could be assessed with photographic records.

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