Bilateral cleft lip and nasal repair

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Surgery

Background:

• Bilateral cleft lip and nasal repair presents significant surgical challenges.
• Existing techniques often result in unsatisfactory aesthetic and functional outcomes.
• The need for improved reconstructive methods is critical for patient well-being.

Purpose of the Study:

• To present a modified staged surgical technique for bilateral cleft lip and nasal repair.
• To address limitations of traditional Millard and Manchester repairs.
• To achieve superior aesthetic and functional results, particularly in nasal projection and central lip form.

Main Methods:

• A staged surgical approach involving lip repair at 3 months and columellar lengthening at 18 months.
• Modification of traditional Millard and Manchester techniques.
• Reconstruction of the central tubercle using a triangular prolabial dry vermilion flap augmented by lateral vermilion flaps incorporating the orbicularis oris muscle.

Main Results:

• The technique provides excellent nasal projection and improved lip function.
• Enhanced central vermilion fullness and minimized sacrifice of lateral lip segments.
• Positive clinical outcomes demonstrated through surgical examples.

Conclusions:

• The modified staged repair offers a viable solution for complex bilateral cleft lip and nasal deformities.
• This technique improves upon traditional methods by focusing on key reconstructive elements.
• The approach yields excellent aesthetic and functional results for patients.