An attempt to reduce the visible scar in primary cleft lip repair

Abstract

MODERN cleft lip surgery attempts to provide a nose and lip which are normal in function and appearance. Unfortunately the result is often marred by a noticeable scar, however fine it may be. In some patients the scar draws attention to the lip due to broadening, depression or a poor colour match with the adjacent skin. An attempt has been made to reduce the visible scarring in the repaired lip using an idea based on a simple observation made during the treatment of facial abrasions and lacerations: wounds confined to the epidermis and superficial layers of the dermis healed without visible scars but those which penetrated more deeply, particularly if they reached the fat, always left noticeable scars. It was considered that, if the repair of a cleft lip could be designed so that the only visible portion of the repair was confined to the superficial layers of the skin, it might be possible to hide the main scar. It was assumed that the skin of the lip would be sufficiently opaque to hide the scar and that a wedge-shaped strip of skin (without subdermal fat) would survive on the dermal plexus.