No abstract available.
Cleft Lip* ; Congenital Abnormalities*

A notching deformity of the vermilion is one of the most common secondary lip deformities following unilateral cleft lip repair. It is due to inadequate approximation of the orbicularis marginalis muscle, vertical scar contracture, and inappropriate adjustment and suturing of the vermilion. During the primary repair, symmetric construction of vermilion is difficult. This is because the thickness and shape of the vermilion is different on both sides of the cleft. To prevent notching deformity of the vermilion, authors designed the incision line such as Tongue-in-Groove on the vermilion and has been utilizing this technique for the last several years and obtained quite satisfactory results. Hereby we present the technique and result.
Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Contracture ; Lip

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Lip* ; Nose*

lip operation or repeated secondary surgeries can result in tightness of the upper lip. In case, the degree of the resulting side-to-side tension is very severe, the possibility of a lip switch flap must be considered. When the lip tightness accompanies a loss of more than two-thirds of the Cupid's bow, an Abbe flap is an alternative. The disadvantages of Abbe flap are scar formation on the lower lip, design of incision line on the upper lip, disharmony of colors, and the dysfunction of the orbicularis muscle. These problems have been recognized in the literature and extreme discretion has been advised in its application. We experienced four cases of Abbe flap operation which were designed differently to correct the secondary unilateral or bilateral cleft-lip nasal deformities. The Abbe flap operations resulted in removal of the scars and tightness of the upper lip, reconstruction of the Cupid's bow, lengthening of the columella, and therefore secondary cleft-lip nasal deformity could be corrected. It is thought that carefully applied Abbe flap is an appropriate method to relieve horizontal tightness or flattening of the upper lip which occured after primary operation of cleft lip.]]>
Cicatrix ; Cleft Lip ; Congenital Abnormalities ; Lip

A case of 13-year-old female with three-pairs/six-lines of labial frenulums and thumb and forefinger's deformity was reported. The frenulums of inferior lip were bigger than frenulum of superior lip. There was no family history and her mother didn't ill with infectious disease and injury in gestation.
Adolescent ; Female ; Humans ; Lip ; abnormalities ; Thumb ; abnormalities

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Nose*

No abstract available.
Cleft Lip* ; Congenital Abnormalities* ; Skin*

The secondary correction of cleft lip nasal deformity (CLND) presents difficult surgical problems. Characteristically, nostrils are asymmetric. The present study was aimed to examine and compare the effect of Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base for augmentation of the nostril with or without lengthening the columella in CLND. The subjects were 28 patients with unilateral cleft lip, who had secondary nostril correction. The nostril correction methods were Straith's alar web Z-plasty, Millard's alar web Z-plasty, alar web excision, and lateral V-Y advancement of the alar base. Facial photographs were taken before and 20 days after the operation. By using Adobe photoshop, the columella length and the nostril width were measured from the facial frontal photograph and Worm's eye view. The degree of improvement was calculated and statistically analyzed. The degree of improvement of the columella length using Straith's alar web Z-plasty was 70.20%. And then Millard's alar web Z-plasty was 55.01%, alar web excision was 39.93%, and lateral V-Y advancement of the alar base was 16.38% in order. The degree of improvement of the nostril size using lateral V-Y advancement of the alar base was 55.26%. And then alar web excision was 52.72%, Millard's alar web Z-plasty was 34.86%, and Straith's alar web Z-plasty was 16.06% in order. Straith's alar web Z-plasty and Millard's alar web Z-plasty resulted in elongation of the columella, equalization of asymmetrical nostril, and enlargement of small nostrils. Alar web excision enlarged nostrils and restored symmetry. Lateral VY advancement of the alar base increased nostril width and enlarged nostrils. These results indicate that the correction of nostrils improve the shape and the symmetry of the nostrils in CLND.
Cleft Lip* ; Congenital Abnormalities* ; Humans

The tissue deficiency in the upper lip after cleft lip repair produces a tight lip, and an Abbe flap procedure is indicated. In order to increase the mobility of the pedicle and decrease the distortion of the lips at transfer, a procedure has been developed in which the pedicle is cut all around soft tissue leaving only a inferior labial artery. Therefore, the Abbe flap which is an arterial flap has been converted to an island flap. The authors performed 15 cases(14 men and 1 woman) of the correction of a tight lip in cleft lip deformities between 1986 and 2000. The patient ranged in age from 18 years to 33 years at the time of surgery, with a mean age of 24.4 years. From 1 to 14 years(mean, 9.7 years) postoperatively, the patients were evaluated by the photogrammetric analysis using preoperative and postoperative photograph, and the ordinary scale method. By the photogrammetric analysis, the upper vermilion contour index and the lip protrusion index were measured. The upper vermilion contour index is the percentage of the surface distance of the upper vermilion ridge to the mouth width. The lip protrusion index is the percentage of the labiale superius-tragion to the labiale inferius-tragion. One represented the correction of the horizontal deficiency in the upper lip, and the other showed the protrusion of the upper lip in relation th the lower lip. By the ordinary scale method, "excellent" aesthetic results were noted. In conclusion, the Abbe island flap provides maximal flexibility without reducing its viability and an accurate adaptation in the defect of the upper lip can be made. The upper vermilion contour index and the lip protrusion index represent objectively the effects of the Abbe island flap.
Arteries ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Male ; Mouth ; Pliability

PURPOSE: Deformities after bilateral cleft lip repair usually involve the philtrum and the central upper lip, which presents as wide philtrum, wide Cupid's bow, whistling deformity and prominent prolabium. The object of this study is to introduce a simple method to correct such deformities of bilateral cleft lip, that is the redo-operation following the modified Millard's method. METHODS: We present 2 patients with secondary deformities of the philtrum and central upper lip after bilateral cleft lip repair. A simple design was used to excise the excessive skin and mucosa of the central upper lip, and the philtrum and Cupid's bow were restored to the standard average width of Korean population. RESULTS: The wide central upper lip and philtrum were successfully restored to the appropriate width(10-12mm) and shape. Also the border of the red vermilion was aligned properly resulting in a good contour of the upper lip. Both patients were satisfied with the results. CONCLUSION: In patients with wide philtral deformities, our simple method can be utilized for a satisfying result.
Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Mucous Membrane ; Singing ; Skin