Dermis Reconstruction and Dermis Fat Graft through an Intraoral Incision: A New Method to Correct the Furrowed Philtral Column Deformity in Lesser-Form Cleft Lip

Abstract

Minor cleft lip deformities are also called lesser-form cleft lips. A furrowed philtral column is one of the important characters of these deformities. Many surgical methods have been adopted to correct it with less than satisfactory results. In this article, a dermis reconstructive method was introduced. From 2003 to 2010, 35 patients with lesser-form cleft lip were treated in our center. Through an intraoral and vermilion incision, the oral side of the orbicularis oris muscle on the affected side was dissected. Through a vermilion and perialar incision, the dermal side of the orbicularis oris muscle was dissected along the furrow. After restoring orbicularis oris muscular ring continuity, if necessary, the underdeveloped dermis was reconstructed with three sutures along the furrow. To reinforce lip thickness on the affected side and increase the philtral column prominence, retroauricular dermis fat was grafted between the muscle and skin. Thirty-five patients with lesser-form cleft lip were treated with dermis reconstruction and retroauricular dermis fat grafts. Congenital lip depressions were well corrected, and the philtral column prominences were reconstructed. The follow-up period was 6 to 20 months. All patients were satisfied with their results. Dermis reconstruction and dermis fat grafting through an intraoral incision is effective in repairing a furrowed philtral column deformity in lesser-form cleft lip.