Unilateral Cleft Lip and Nasal Deformity: 8 Principles for Symmetrical Correction
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Published on: June 20, 2018
John G Meara1,2, Kerry A Morrison1,2
1From the Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.
Background:
This article describes the first author's hybrid approach to unilateral cleft lip and nasal deformity repair, which has evolved from the Skoog, Millard, and Fisher techniques.
Methods:
Key differentiating technical surgical pearls are delineated, including drawings and video content.
Results:
The first author incorporates 2 triangular skin flaps from the lateral lip into releasing incisions in the medial lip element. Furthermore, this technique obviates the need for a columellar back-cut or a C-flap, as both create a scar that distorts the natural columellar-labial junction and the appearance of the footplate region. Instead, the technique described here creates a natural skin "apron" that flows from the columella over the footplate region laterally on both sides and smoothly and gradually onto the philtrum in the midline.
Conclusions:
The first author highlights 8 surgical principles for symmetrical correction.
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