A Reconstruction of Upper Lip using Abbe Flap

ABSTRACT

Reconstruction of upper lip defects presents a challenge to the facial plastic and reconstructive surgeons. Flatness, shortness, and retrusion of the upper lip of cleft patients are caused by a combination of the initial maxillary hypoplasia, the subnormal maxillary growth, and the lack of upper lip soft tissue. Although the routine use of Abbe flaps has been questioned, various modifications of the flap have been used for the repair of deficient upper lip soft tissue. Between 1991 and 2000, the author performed a variety of Abbe flaps in 10 patients. The patients consisted of 5 males and 5 females (3 unilateral clefts, 3 bilateral clefts, 2 cancers and 2 traumas). Mean age at the time of the procedures was 28.5 years (from 16 to 48 years). The pedicles of the flaps were divided 10 to 14 days postoperatively. The follow-up period ranged from 9 to 27 months (mean=17 months). To evaluate the outcome of Abbe flaps objectively, an anthropometic ratio was measured in preoperative and postoperative photographs. This values were compared with the values found in non-cleft patients. Each patient showed a more natural contour of the upper lip. We have found that Abbe flaps were clinically useful, and our results were functionally and cosmetically acceptable. This study indicates that the lips are in better harmony postoperatively than they were preoperatively.