Full-Face Versus Cropped Nasolabial Assessment of Appearance Outcomes in Cleft Lip Repair: A Review

Evaluating surgical outcomes in cleft lip reconstruction relies on a detailed assessment of the nasolabial region. There remains no internationally standardised approach to this assessment. The use of facial cropping to isolate the nasolabial region, while common, prevents appraisal of overall facial balance. This scoping review aims to compare full-face and cropped assessments of aesthetic outcomes following cleft lip reconstruction.

Articles were retrieved from Medline and Embase. The selected studies were analysed based on whether they focused on nasolabial, full-face, or a combined approach to aesthetic evaluation. Inclusion criteria encompassed studies that evaluated the methods used for postoperative assessment, with specific attention to reliability, accuracy, and bias in scoring systems.

Nineteen articles were eligible for inclusion. Nasolabial-cropped evaluation has greater precedent and is widely supported for its reliability. Early studies excluded full-face evaluation due to concerns about bias. However, recent studies challenge this perspective, suggesting that full-face evaluation is similarly reliable and provides a more comprehensive understanding of facial proportions and growth. No studies directly compared whether full-face or nasolabial assessments better align with patient-reported outcomes.

Full-face analysis should not be excluded from the armamentarium of outcome instruments. The evaluation is similarly reliable and offers a more complete appraisal of facial balance over time. This facilitates further understanding of facial development beyond the ranking of primary surgical outcomes.