The Comprehensive Correction Of Secondary Upper Lip Deformity Of Cleft Lip

Objective:The purpose of this study is to research an effective method to deal with the secondary upper lip deformity of cleft lip.Methods:Twenty patients(26 males and 19 females) with ages ranging from 12 to 55, consecutively, with cleft lip upper lip deformity between February of 2006 and February of 2009 are included in this study. All of them have received primary treatment. At this time we use the general method to correct the secondary upper lip deformity of cleft lip after deep research of the pathological anatomy of upper lip and the reasons of deformity. Before operation, preoperative photographs should be taken. Routine examination should be adopted. Firstly we mark the anatomic landmarks of the upper lip, design the incision and measure the datas. We resect the upper lip scar along the designed incision, release the deep layer tissue, reconstruct the orbicularis oris and reposit the anatomic landmarks, using flaps if necessary. The incisions will be closed by 3-0 and 6-0 suture finally. Take photographs again postoperatively. The postoperative follow-up is 3 to 15 months.Results:All the patients who received the general method have a good result without infection and necrosis. The surgery reposited anatomic landmarks significantly, and improved symmetry and appearance of the upper lip.Conclusions:1,The individualized treatment basing on the pathological anatomy is effective to repair the secondary upper lip deformity of cleft lip.2,The concept of comprehensive correction to repair every part of the upper lip deformity is quite important to the procedure.3,The method using autogenous tissue to correct deformity is effective to obtain better postoperative appearance.4,Comparing the geometric principles between Z flap and V-Y flap for the first time to avoid blindness in chosing flaps. The flaps can be designed without restriction of routine ratio in some tissues with good flexibility and blood supply.