The V-shaped mini flap method for microform cleft lip repair
Received: 13 October 2016 /Accepted: 20 November 2016 /Published online: 20 December 2016
Springer-Verlag Berlin Heidelberg 2016
Background We have devised a new operative technique for
microform cleft lip repair via the use of a V-shaped flap meth-
od. From 2006 to 2015, nine patients with unilateral cleft lip
diagnosed as mini-microform cleft lip or microform cleft lip
by the classification of Yuzuriha and Mulliken, were recorded.
Methods With our procedure, a V-shaped mini flap with the
vermillion border serving as the vertexisinsertedintothein-
cised area along the vermillion border on the affected side, there-
by allowing reliable correction of the vermillion border notch.
When this procedure is applied to cases of microform cleft lip,
the white lip’s linear mark is resected totally, followed by over-
lap suturing of the orbicularis oris muscle from the incised area
to correct philtrum ridge deviation and nasal alar base lateral
deviation. In cases of mini-microform cleft lip, the extent of
resection of the skin and mucosa is reduced to the minimum
necessary level to reduce the scar size as far as possible.
Results This procedure was used for the treatment of micro-
form cleft lip in six cases and mini-microform cleft lip in three
cases. The mean age at operation was 13.3 months (range 6–
45 months). There were no postoperative complications;
moreover, no patient required additional surgery.
Conclusions Regarding postoperative clinical findings, the
scar was not evident because it was identical to the philtrum
ridge. Furthermore, the cupid’s bow was symmetrical, and con-
striction at the vermillion’s free margin had been corrected.
Level of Evidence: Level IV, therapeutic study.
Keywords Cleft lip
Microform cleft lip
Published articles on microform cleft lip focus primarily on
the phenotype; little has been written on operative technique.
Repair of a microform cleft lip is rarely mentioned in the
surgical chapters of the standard multiauthored and multidis-
ciplinary textbooks on cleft lip-cleft palate. We have devised a
new operative procedure for microform cleft lip repair via the
use of a V-shaped mini flap method. This procedure can repair
the notch at the vermillion border and the linear mark of white
lip in a reliable manner, enabling simultaneous reconstruction
of the orbicularis oris muscle. We have applied this procedure
to nine patients and obtained favorable results in all cases, as
Patients and methods
From 2006 to 2015, nine patients with unilateral cleft lip di-
agnosed as mini-microform cleft lip or microform cleft lip by
the classification of Yuzuriha and Mulliken , were record-
ed. All patients underwent primary cleft repair with our surgi-
cal procedure. Six male patients, 3 female patients, and ap-
pearance of disease by the left side was seven patients, and the
right side was two patients.
Point a is marked in the median region of vermillion, point b at
the cupid’s bow peak on the intact side, point c at the medial
* Naoshige Iida
Department of Plastic and Reconstructive Surgery, Japanese Red
Cross Akita Hospital, 222-1 Naeshirozawa, Saruta, Kamikitate,
Akita City 010-1406, Japan
Eur J Plast Surg (2017) 40:183–186