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Lip lift surgery using bullhorn technique without any visible scar

29/6/2016

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A 24 year old girl from Dubai, a known case of unilateral cleft lip and palate reported to our hospital seeking for lip correction. Primary cleft lip repair was done elsewhere resulting in thinning of upper lip. Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected this defect using bullhorn lip lift technique.

There are different types of lip lift surgery. The most commonly used lip lifting technique is known as the ‘bullhorn lip lift’. Pre-operative markings on the skin ensure the lip lift is approximately symmetric. Advancement of the inferior edge of skin directly beneath the nasal base lifts the lip, producing more visible vermilion and about 3 mm of teeth show at rest. The position of the final incision is such that it is located within the shadow of the nose. Meticulous technique produces an almost invisible scar. The amount and width of skin excised is individualized depending on the desired aesthetic goals. Lip lifts using this technique provide an immediate, dramatic, and permanent result.
Thin upper lip due to secondary cleft lip defect
Using Bullhorn technique the skin along with subcutaneous tissue excised to raise the lip
Immediately after suturing by raising the inferior border of the incision to the base of the ala raising the vermillion
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Nose correction & Abbe flap procedure for lip correction in cleft patient

8/6/2015

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A 25-year-old man came to the hospital wanting to correct his lip and nose defect to improve his appearance. He was born with bilateral cleft lip and palate which was previously operated elsewhere. His upper lip was very thin and his nose appeared deformed making him very self-conscious about his appearance.

Maxillofacial Surgeon Dr. S. M. Balaji successfully performed an abbe flap procedure for lip correction and nose correction. A flap of tissue was taken from the lower lip, rotated across the mouth and used to reconstruct 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. Once blood supply was established, the flap was divided giving the upper lip a more natural, improved form. The broad nose was reshaped to make it more proportionate and balanced. Following surgery the man was very happy to have an improved facial profile.
Preoperative facial view showing defective cleft nose and lip
Preoperative profile view showing depressed nasal tip due to missing columella and missing upper lip prominence
Immediately after suturing with columella enhancement and upper lip correction
Immediately after suture removal following Abbe division showing enhanced appearance of nose and upper lip without much surgical marks
Profile view showing augmented nose profile and columella and proportionate lips were obtained giving enhanced appearance
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Successful cosmetic cleft nose correction with lip revision

18/2/2015

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A 28-year-old man from Kolkata reported to our hospital seeking specialized treatment to correct his cleft nose defect. He was previously operated for cleft lip and palate elsewhere in his childhood. Due to the cleft defect his nose was collapsed on the right side and it affected his facial appearance. He wanted to have unsightly lip scar correction also in the same surgery.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed the rhinoplasty or nose correction. A costochondral graft (rib graft) was harvested and used to reconstruct the collapsed nasal framework. The surgery was approached from inside the nose so there will be no scar formation. Alar base on the right side was at a lower level compared to other side due to cleft defect. This was corrected by raising the floor of nose intraorally using costochondral graft thus nose was made symmetrical on either side. 

Huge unsightly lip scar defect which was formed due to previous lip surgery done elsewhere also corrected and shape of the vermillion was reconstructed. Immediately after surgery, the nose appeared sharp and definite giving a more pleasing appearance. The patient was very happy to have his nose and lip defect corrected without much visible surgical marks. 
Preoperative facial view showing asymmetric nose profile and depressed alar base on the left side due to cleft defect
Preoperative view showing depressed alar base on the left side due to cleft bone defect in the base of the nose
Harvested costochondral rib graft to augment the defective cleft nose
Costochondral rib graft used to raise the depressed dorsum of the nose
Cleft lip revision and augmented dorsum of the nose giving enhanced appearance
Alar base on the left side of the nose was raised and approximated to the right side without any visible surgical marks
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