Background: The incision design for correcting a unilateral cleft lip is important because all subsequent stages of surgery depend on the access and maneuverability of the incision. This prospective cohort study compares the aesthetic and functional outcomes of three different skin incisions for primary unilateral cleft lip repair.
Methods: Patients with complete unilateral cleft lips (n = 1200) were enrolled and divided into three groups of 400 patients. Each group of patients was operated on with the Millard incision, Pfeifer wave line incision, or Afroze incision. Outcome assessments were performed 2 years postoperatively and consisted of assessment of the white roll, vermilion border, scar, Cupid's bow, lip length, nostril symmetry, and appearance of alar dome and base.
Results: With regard to white roll, vermilion border, scar, Cupid's bow, and lip length, the Afroze incision always gave superior results compared with the Millard or Pfeifer incision. Depending on the cut-off for treatment success, the Afroze incision also showed better results regarding nostril symmetry. With respect to the alar base and alar dome, all three incisions showed comparable outcomes.
Conclusion: The Afroze incision is superior regarding a broad spectrum of outcomes in a heterogeneous population of patients with unilateral cleft lip.