She was brought to our hospital for surgical correction when she was 8 months old. Her bilateral cleft lip deformity was addressed first. She had a very wide cleft with a mobile premaxilla. Her prolabium was also very tiny along with a very short columella. There was also very minimal tissue for reconstructing the lip.
She underwent a single stage repair utilizing Paul Black’s technique. No cross incision was made at the prolabium. Available prolabium and columella were utilized for reconstructing the philtral column and Cupid’s bow.
This was followed by creation of the nasal floor and vermillion. Bilateral C-flaps were utilized for this. Extreme care was taken as there was very minimal tissue available. This was followed by meticulous three layer closure of the cleft lip under loupe magnification. Orbicularis oris muscle was approximated at the midline. This was followed by approximation of the subcutaneous tissue and skin.
Her parents were extremely happy with the results of the surgery.