Lateral vermilion border transposition flap to correct vermilion deformities with unilateral or bilateral cleft lip

Abstract

Previously, bilateral lateral vermilion border transposition flaps were reported to correct whistling lip deformity in patients with cleft lip. This study examined the long-term outcome in these patients and modified the procedure. Here, the use of this procedure is reported in 69 cleft lip patients. The follow-up period after the operation ranged from 4–14 years. In addition to the standard method, a unilateral flap was applied for asymmetrical vermilion and small bilateral flaps were applied to loosen the transverse tightness of the vermilion. The asymmetry of the tightness was improved in all patients. The reconstructed tubercle diminished in volume gradually over a few years postoperatively. Secondary deformities after its use were subtly everted tubercle during smiling (18.8%) and irregularities on the labial-free margin (21.7%). They were corrected by minor follow-up revision. Although it is necessary to wait several years until the postoperative shape has stabilised, this is a simple and widely available method to reconstruct a naturally-shaped vermilion in cleft lip patients.

Key Words::

• Whistling lip deformity
• cleft lip
• vermilion
• transposition flap