Late correction of orbicularis discontinuity in bilateral cleft lip deformity

The absence of muscle in the prolabial segment and the failure to identify and join the fibers of the orbicularis muscle from the lateral lip segments at the time of initial lip repair frequently result in a characteristic bulge above the vermilion laterally. This bulge is caused by the bunching of the orbicularis oris as the result of its discontinuity in the prolabial segment. Late repair of this deformity is possible. In a series of fifteen patients with previously repaired bilateral cleft lips, lateral mobilization and midline suturing of the separated segments of the orbicularis oris muscle have been employed to correct the orbicularis bulge. Significant improvement in oral animation and in facial aesthetics have been noted in these patients.