Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
권호 표지

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

양측 구순비변형 환자의 이차성 교정에 있어서 V-Y 전진 피판술 또는 정중 구순 비판술을 이용한 비주 연장술

  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, Pusan National University) ;
  • Moon, Jae Sul (Department of Plastic and Reconstructive Surgery, Pusan National University) ;
  • Kim, Sang Ho (Department of Plastic and Reconstructive Surgery, Pusan National University) ;
  • Nam, Su Bong (Department of Plastic and Reconstructive Surgery, Pusan National University) ;
  • Kang, Young Seok (Department of Plastic and Reconstructive Surgery, Pusan National University)
  • 배용찬 (부산대학교 의과대학 성형외과학교실) ;
  • 문재술 (부산대학교 의과대학 성형외과학교실) ;
  • 김상호 (부산대학교 의과대학 성형외과학교실) ;
  • 남수봉 (부산대학교 의과대학 성형외과학교실) ;
  • 강영석 (부산대학교 의과대학 성형외과학교실)
  • Received : 2005.04.20
  • Published : 2005.09.10
Download PDF
⟨ Previous Next ⟩

Abstract

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.

Keywords

References

  1. Bitter K: Repair of bilateral clefts of lip, alveolus and palate. Part 2: Concomitant lip closure and columella lengthening after lip adhesion. J Craniomaxillofac Surg 29: 44, 2001 https://doi.org/10.1054/jcms.2000.0186
  2. Bardach J, Salyer KE: Surgical techniques in cleft lip and palate. Chapter 6: Correction of the nasal deformity associated with bilateral cleft lip. 2nd ed, Chicago. Year book medical publisher. 1991, p 197
  3. Lew HS, Park JS, Uhm KI, Lew JM: Columella lengthening with fork flap in secondary bilateral cleft lip nose deformity. J Korean Soc Plast Reconstr Surg 22: 564, 1995
  4. Suh JO, Park JY, Kim YS, Jung SG, Chun KS: Use of central lip flap in secondary bilateral cleft lip patient. J Korean Soc Plast Reconstr Surg 21: 684, 1994
  5. Koh KS, Ock JJ: Columellar lengthening using the inter- digitation of triangular flaps. Aesth Plast Surg 26: 78, 2002 https://doi.org/10.1007/s00266-002-0043-0
  6. Blair VP, Lettermann GS: The role of the switched lower lip flap in upper lip restorations. Plast Reconstr Surg 5: 1, 1950 https://doi.org/10.1097/00006534-195001000-00001
  7. Gillies SH, Millard DR: The principles and art of plastic surgery. Boston, Little, Brown & Co. 1957, p 319
  8. Cronin TD, Upton J: Lengthening of the short columella associated with bilateral cleft lip. Ann Plast Surg 1: 75, 1978 https://doi.org/10.1097/00000637-197801000-00015
  9. Shin KS, Lee CH: Columella lengthening in nasal tip plasty of orientals. Plast Reconstr Surg 94: 446, 1994 https://doi.org/10.1097/00006534-199409000-00004
  10. Chen TH, Chen YR: Extended open-tip rhinoplasty with three V-flaps for secondary correction of bilateral cleft lip nasal deformity. Ann Plast Surg 37: 482, 1996 https://doi.org/10.1097/00000637-199611000-00005