Supportive Therapies for Reducing Hypertrophic Cleft Lip Scars: A Systematic Review

ObjectiveTo evaluate the effectiveness of supportive therapies in improving scar quality following primary and secondary cleft lip repair.DesignSystematic review conducted according to PRISMA 2020 guidelines. Literature searches were performed in PubMed, Embase, and the Cochrane library. Due to clinical and methodological heterogeneity, findings were synthesized narratively.SettingAcademic and tertiary care centers.PatientsPatients undergoing primary or secondary cheiloplasty who received supportive therapies for scar management.Outcome MeasuresScar quality assessed using the Vancouver Scar Scale (VSS), Visual Analog Scale (VAS), scar width measurements, photographic evaluation, and patient-reported outcomes.ResultsEleven studies met the inclusion criteria. Evaluated interventions included Botulinum Toxin Type A (BTA), laser and light-based therapies, platelet-rich plasma (PRP), and silicone gel. BTA consistently improved scar appearance and reduced scar width following cheiloplasty. Energy-based therapies, particularly fractional CO₂ laser and pulsed dye laser (PDL), demonstrated significant improvements in scar texture, vascularity, and overall appearance. PRP was associated with reduced scar widening, while silicone gel showed efficacy comparable to silicone sheets in controlling hypertrophic scar formation. No major treatment-related complications were reported.ConclusionSupportive therapies may improve scar quality after cheiloplasty, with the strongest evidence supporting BTA and energy-based treatments. Further high-quality prospective studies are required to establish standardized treatment protocols.