Current approaches to cleft lip revision

Area of Science:

• Plastic Surgery
• Craniofacial Surgery
• Pediatric Surgery

Background:

• Cleft lip repair necessitates lifelong multidisciplinary care.
• Adolescent lip revision surgery is often required for optimal function and symmetry.
• Variability in primary repair techniques highlights the need for secondary repair guidance.

Purpose of the Study:

• To review current techniques for secondary cleft lip repair.
• To provide guidance for managing secondary cleft lip deformities.
• To categorize secondary deformities and their respective treatments.

Main Methods:

• Review of recent literature on secondary cleft lip reconstruction.
• Classification of secondary deformities into superficial and muscle-related categories.
• Identification of emerging and established surgical and non-surgical methods.

Main Results:

• Superficial reconstruction methods include botulinum toxin, silicone sheeting, local flaps, fat grafting, and CO2 laser ablation.
• Muscle-related reconstruction involves pedicled prolabial flaps, modified Abbe flaps, and orbicularis oris eversion.
• Superficial deformities may require less invasive treatments, while muscle deformities often necessitate comprehensive revision.

Conclusions:

• Secondary cleft lip deformities are classified as superficial or muscle-related.
• Superficial issues benefit from targeted treatments; muscle issues require extensive revision.
• Patient-centered care and appropriate timing are crucial for successful outcomes and psychosocial well-being.