Our Surgical Repair for Macrostomia with Two Novel Small Triangular Flaps: Long-Term Follow-Up and Results

Area of Science:

• Plastic Surgery
• Congenital Abnormalities
• Surgical Techniques

Background:

• Congenital macrostomia repair requires careful consideration of both functional and aesthetic outcomes.
• Achieving normal orbicularis oris muscle function and lip symmetry is crucial for successful correction.

Observation:

• A retrospective analysis of 12 primary macrostomia repair cases performed between 1996 and 2013.
• The novel technique involves two small triangular flaps incorporating a superficial layer of orbicularis muscle.
• Flap lengths were optimized: 1.5-2.0 mm for medial and 5-8 mm for lateral flaps.

Findings:

• The technique preserved dynamic muscle action by retaining muscle fibers attached to skin within triangular flaps.
• Suturing was performed across orbicularis muscle bundles.
• Follow-up ranging from 3 to 21 years demonstrated satisfactory lip symmetry and scar characteristics.

Implications:

• This surgical approach is highly effective for primary macrostomia repair.
• Preservation of muscle-skin integrity is key to maintaining dynamic function.
• The technique offers a reliable method for reconstructing natural appearance and dynamic function of the oral commissure.