Secondary cheilorhinoplasty of bilateral cleft lip and nose deformities

Columellar Lengthening Using V-Y Advancement Flap or Central Lip Flap in Secondary Correction of Bilateral Cleft Lip Nose Deformity

Even though it is generalized to perform synchronous lip and nasal correction, there are some cases in need of secondary correction of cleft lip nose deformity. In these procedures, the lengthening of columella plays an important role. We performed eighteen cases of the secondary cleft lip nose deformity correction using two different methods from 1997 to 2003. The central lip flap was used in eight patients and V-Y advancement flap in ten patients. Additional procedures including reverse U-incision, interdomal fixation sutures and suspension sutures were used for correction of combined deformity. Silastic nasal retainers were kept in all patients for 6 months. Both of central lip flap and V-Y advancement flap seems to be a good technique for lengthening columellar soft tissue. But new columella after V-Y advancement flap appeared to be too narrow and a bit unnatural looking and central lip flap left additional scar on the upper lip although it was conspicuous. We think that central lip flap is a better technique in a case with wide philtrum and narrow columella and V-Y advancement flap can be another choice in a columella with sufficient width.