Growth of the unilateral cleft lip

Growth discrepancies have frequently been noted following surgery for the repair of clefts of the lip. A long lip is often noted months or years after LeMesurier, Tennison, or Asensio repair, whereas a short lip is noted after the Millard repair. We evaluated the problem by measuring 112 unrepaired unilateral completed cleft lips in a homogeneous population. Patients of all ages from newborn through adults were included. The study showed that a cleft lip has ten to twenty per cent greater growth in the transverse direction parallel with the orbicularis muscle than in the vertical direction perpendicular to the muscle. Thus, procedures such as those of LeMesurier and Asensio that transpose tissue from transverse to vertical will lead to excessive vertical growth. Lip growth is slightly decreased along the cleft margins but does not account for the short lip seen after the original Millard repair. Lip shortness occurs soon after repair because of scar contracture but tends to resolve with the passage of time.