This child was born with unilateral macrostomia, which was on the left. There were no other associated structural abnormalities. Her parents presented at our hospital for corrective surgery. Treatment planning was explained to them and they consented to surgery.

The new commissure was marked to ensure postsurgical symmetry with the normal right side. Orbicularis oris was reconstructed using the vermilion return flap. Repair was performed in three layers using the muscles, subcutaneous tissue and skin. This would result in negligible scar formation.

She will now be able to speak clearly and eat without dribbling. Her appearance was also completely normalized with establishment of symmetry. Her parents were very pleased with the results of the surgery.

This little girl was born with a right-sided hemifacial microsomia with macrostomia. Hemifacial microsomia might be genetic or can be acquired through disruption of in utero vascular supply to the facial region. It is most commonly unilateral.

She had right-sided macrostomia, a short lingual frenum with resultant tongue tie and a prominent right preauricular cartilaginous ear tag.

The short lingual frenum was addressed first. Fibers of the lingual frenum were dissected free and the tongue tie was released. Her right-sided macrostomia was corrected using a vermillion return flap technique. This involved reconstruction of the modiolus on the right side.

The orbicularis oris muscle was first identified and sutured. Buccinator was then identified and sutured. This resulted in a symmetrical reconstruction of the angle of the mouth.

Attention was then turned to the right ear tag. An incision was made and the cartilaginous part of the ear tag was dissected and excised. The incision was then closed resulting in establishment of good facial esthetics for the little girl from the surgery.
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Her parents were extremely satisfied with the results of the surgery.

​This is a case of macrostomia (lateral facial cleft) in a 1 year old baby girl from Siliguri. The parents brought the baby seeking the best surgical treatment for the correction of wide mouth and the asymmetric appearance of the baby without much visible scars on the face.
Surgical correction of macrostomia is challenging and more complex as it aims in restoring back the normal appearance while at the same time maintaining the normal functions like speech, blowing, etc.
Maxillofacial Surgeon Dr. S. M. Balaji successfully corrected the macrostomia using vermillion return flap technique. Results are immediate and the parents feel very happy to see the negligible scar formation, following suture removal.