Columellar lengthening using the interdigitation of triangular flaps

The most common and striking feature of the bilateral cleft lip nose deformities is a short columella. This problem can be resolved by lengthening the columella. In this article the authors lengthen the columella using the interdigitation of triangular flaps in the upper lip tissue. The columellar elongation is made by an advancement of nostril tissue and an interdigitation of the triangular flaps. Our method shows good aesthetic results. The triangular flaps that are intersected without excision make the columellar base pyramidal and medially directs the alar bases, narrowing the width of the nostril sills. Though the optimal columellar lengthening procedure can vary according to the deformed anatomy of the nose and lip, this method deserves to be considered especially in patients who have sufficient tissue in their nostril sills.