Post-cleft Lip, Nose Deformities
Cleft lip is a congenital craniofacial anomaly. In China, the chance of having a newborn with cleft deformity is about 1 in 1,100. The cleft lip is usually surgically repaired at around 3 months of age. In the past decades, various methods such as Le Mesurier’s, Tennison’s and Millard’s have been employed to yield good initial results. However, as the patient grows into adulthood, the post-cleft deformities of the lip and nose gradually become more prominent until facial growth concludes at around age 18.
The main reason can be attributed to difference in growth rates of the normal and the cleft side, causing the lip to become irregular in shape. Other factors include failure to mobilise the involved muscle back to the normal anatomical position and the retention of the so-called “excess tissue” in the initial repair.
Surgeries For Post-cleft Deformities Of The Lip & Nose
Malalignment of Vermillion Border
- Z-plasty
- Excision of excess tissue
Whistle Deformity of Upper Lip
ingle or multiple Z-plasty
Small Vermillion Tubercle
- Release of upper lip frenulum
- VY-plasty
Unequal Philtral Peak Height
- Cleft side peak is higher: Millard’s rotational advancement to lower the peak
- Cleft side peak is lower: Excise excess tissue on the cleft side, provided the patient’s facial growth is complete
Short Philtrum
Usually for the patient with previous bilateral cleft lip
* Inverted VY-plasty if no nasal deformity
* If there is nasal deformity, inverted VY-plasty and advancement forked flap
For Short Columella and Flaring of Alar
Open rhinoplasty with realignment of alar cartilage
* VY-plasty for the unilateral cleft lip patient
* Advancement forked flap for the bilateral cleft lip patient
Look Better, Feel More Confident
Improving your appearance is just as important as treating an illness. As society advances, surgical service for cleft lip patients is no longer limited to primary repair. Secondary cleft revision is also of vital importance. With determination and willingness, patients can drastically improve their appearance and gain renewed confidence and a new lease on life.