One-Stage Reconstruction of Whistle Deformity and the Vermilion Tubercle Using a Modified Bilateral Kapetansky Flap

Whistle deformity is a common secondary complication following cleft lip repair, substantially affecting lip aesthetics and patients' psychological well-being. Although the classic bilateral Kapetansky flap technique described by Kapetansky and the whistle flap technique by Grewal et al are widely used, current approaches still struggle to simultaneously correct the deformity and restore a natural lip tubercle in a single operation, often requiring multiple staged procedures. To address this, the authors developed a modified bilateral Kapetansky flap technique adjacent to the central upper-lip defect, providing adequate soft-tissue augmentation through flap rotation and overlapping. This method effectively corrects the central defect of a whistle deformity while restoring a natural 3-dimensional lip tubercle. Follow-up demonstrated complete deformity correction, smooth contour transitions, symmetrical upper-lip morphology, and high aesthetic satisfaction. The technique is technically straightforward, produces stable outcomes, and is well accepted by patients, representing a practical, efficient approach for one-stage management of a whistle deformity with concurrent tubercle reconstruction.