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Minimal Scar Repair of Unilateral Cleft Lip

Grasseschi, Mitchell F. M.D.

Plastic and Reconstructive Surgery: February 2010 - Volume 125 - Issue 2 - p 620-628
doi: 10.1097/PRS.0b013e3181c82f4c
Pediatric/Craniofacial: Original Articles

Background: Most conventional repairs for unilateral cleft lip are based on the notion that the two joined edges of skin should be the same length. To this end, they incorporate designs that include darts, cutbacks, rotation flaps, and other strategies to match the length of the two segments. As unequal skin edges are routinely joined surgically, it should be unnecessary to incorporate maneuvers in unilateral cleft lip repair to match the segment lengths. A repair that places the scar along the philtral ridge was developed. This eliminates scars that deviate from the aesthetic subunits.

Methods: Since 1982, a procedure has been used for unilateral cleft lip repair that incorporates the Kernahan functional muscle repair with a vertical skin closure, a white roll flap, and a dart at the nasal sill. The results of this lip repair, which does not intentionally match the segment lengths, are reviewed. Photographs of 10 consecutive patients who had their unilateral cleft lips repaired with this technique are presented for critical analysis. The mean age at operation was 15.4 weeks (range, 8 to 30 weeks). The mean postoperative period for the presented photographs was 66 months (range, 31 to 87 months). All of the patients healed without complications, and no revisions were performed.

Results: Preoperative and postoperative photographs of 10 consecutive patients demonstrate that normal lip length can be achieved without scars outside of the aesthetic subunits of the lip.

Conclusion: The unilateral cleft lip deformity is repairable, with excellent results, without incorporating maneuvers to match the lengths of the opposing cut edges.

Chicago, Ill.

From the Department of Plastic Surgery, Northwestern University, and Shriners Hospital for Children.

Received for publication January 28, 2009; accepted August 17, 2009.

Disclosure: The author has no financial interest to declare in relation to the content of this article.

Mitchell F. Grasseschi, M.D.; 2500 Ridge Avenue, Suite 208; Evanston, Ill. 60201;

©2010American Society of Plastic Surgeons