The Revision of Vertical Prolabial Deficiency in Bilateral Cleft Lip Patients: Prolabium Lengthening by Nasolabial Muscle Reconstruction.

BACKGROUND

Vertical prolabial deficiency is a common issue among a significant number of secondary bilateral cleft lip patients. Historically, the Abbé flap has been utilized to augment the volume of prolabial soft tissue. This article introduces an innovative surgical approach for prolabial lengthening through the reconstruction of the nasolabial muscle.

METHODS

From December 2017 to January 2023, 65 secondary bilateral cleft lip patients presenting with vertical prolabial deficiency underwent this novel surgical procedure. The nasolabial muscle was meticulously reconstructed and lengthened. The measurements were taken for the length of the philtrum, vermilion, and the lower facial region. Patient satisfaction regarding the labial morphology was assessed using a structured questionnaire.

RESULTS

The average philtrum length was 9.8 ± 2.2 mm preoperatively, which significantly increased to 13.5 ± 1.3 mm immediately post-surgery (P < 0.05). The average ratio of prolabial length to lower facial length was 0.32 ± 0.03 preoperatively, improving to 0.40 ± 0.04 postoperatively, with a follow-up period ranging from 6 months to 3 years (P < 0.05).

CONCLUSION

The surgical technique described effectively lengthens the prolabium, thereby enhancing the aesthetic appearance of secondary bilateral cleft lip patients with vertical prolabial deficiency.

LEVEL OF EVIDENCE III: This journal requires that authors 33 assign a level of evidence to each article. For a full 34 description of these Evidence-Based Medicine ratings, 35 please refer to the Table of Contents or the online 36 Instructions to Authors www.springer.com/00266.