The diamond vermilion flap--a new technique for vermilion augmentation in cleft lip repair

In most cleft lips patients, the vermilion on the medial aspect of the repair is deficient in height. Not many surgeons have dealt with ways to augment the height of the vermilion at this location. In the unilateral cleft lip, the repair may include the insertion of a small triangular vermilion flap from the cleft side into an incision made for it in the muco-vermilion junction of the noncleft side. We have developed a new technique to further augment the vermilion in incomplete cleft lip patients.

Vermilion remnants may be present in these patients on the scar tissue between the margins of the cleft. A diamond-shaped vermilion flap based on its attachments to the orbicularis oris muscle may be transposed into the noncleft side to an incision made caudal and parallel to the muco-vermilion border. Then the triangular vermilion flap may be inserted just distal to the island flap. Using this method, the vermilion is augmented and the muco-vermilion line parallels more the white skin roll.