Successful reconstruction of the upper lip attempts to maintain the anatomic and physiological relationship of the philtrum (central portion of upper lip) and the base of the nose.

This is the case of secondary cleft lip and nose deformity in a 22 year old boy from Nepal. He is a known bilateral cleft lip and palate patient where the primary cleft lip and palate surgeries where done elsewhere in his hometown. He had defective appearance of the nose and lip due to which he lost his self confidence and he was very conscious about the appearance.
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Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected both the nose and lip defect together using Abbe flap technique. In the first stage a flap of tissue was taken from the lower lip, rotated across the lips and used to reconstruct the thin central portion of the upper lip, with the base of the flap still attached to the lower lip. Simultaneously in the same procedure itself, reduction rhinoplasty was done to correct the broad nose. After blood supply was established in a few days, the second stage surgery to divide the flap was done. The defect was corrected giving the upper lip a more natural, enhanced form. Results are immediate, both the nose and upper lip defect are corrected giving improved appearance and this boosted the boy’s confidence.

A 16 year old boy born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. He was operated elsewhere for primary cleft lip and palate. He had a thin upper lip and broad flattened nose for which he sought treatment.
Maxillofacial Surgeon Dr. S.M. Balaji performed the specialized Abbe flap technique to correct the upper lip. A flap of tissue was taken from the lower lip and used to reconstruct the upper lip with the base of the flap still attached to the lower lip. Once blood supply was established, the flap will be divided giving the upper lip a more natural, improved form.
Simultaneously, the broad nose was reshaped to make them more proportionate and balanced. Following surgery, the nose appeared sharp & defined with more proportionate profile.

A 19-year-old boy from New Delhi, with unilateral cleft lip & palate was brought to our hospital by his parents for expert correction of his nose & lip defect. His cleft lip and cleft palate correction was done elsewhere in his childhood. Now his nose was disproportionately large & upper lip was too thin. He wanted to correct the shape & form of his nose & lips to improve his appearance.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined correction of the nose & lip defect. A medial & lateral osteotomy of the nose was done to reduce the large nose. With this the nose was reshaped & given a more proportionate, balanced form. The lip defect was corrected with Abbe-flap technique. A flap of tissue was taken from the lower lip, rotated across the mouth & sutured to the upper lip with the base of the flap still attached to the lower lip to maintain blood supply. The flap was taken with hair follicles to ensure moustache growth. After 3 weeks once blood supply is established, the flap will be divided, giving the lips an enhanced form, function & appearance. 

A 12 year old boy with bilateral cleft lip and palate reported to our hospital with the complaints of defective upper lip and ill-defined nose tip with depressed nasal bridge. His parents were not happy with the boy’s appearance and he was not able to spell few words due to defective upper lip which made him more depressed. 

Maxillofacial Surgeon Dr. S. M. Balaji skillfully planed to correct his upper lip defect as well as his ill- defined tip of the nose by following Abbe flap technique. Surgery was done in two stages. In the first step, prolabium was raised to increase the columellar length and nasal tip projection. And the cleft lip defect was corrected with Abbe flap technique were lower lip tissue was raised and attached to the upper lip defect region. In the second step, achieving good healing after 25 days the upper and lower lip was surgically separated and thus nose as well as lip defect correction was done simultaneously without many surgical scars. The boy and his family was very happy to see the enhanced appearance of the nose and well aligned upper and lower lips without any surgical scars.