Category: Nose And Lip Correction

Successful cleft nose and lip correction using Abbe flap technique

15/6/2016

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.

Preoperative view showing broad flat nose with defective upper lip

Profile view showing ill defined columella of nose with depressed nasal tip and defective upper lip

Columellar view showing ill defined columella and depressed dorsum of nose with defective upper lip

Immediately after suturing showing raised defined dorsum with corrected lip alignment

Postoperative profile view showing enhanced appearance

Postoperative view showing enhanced appearance of nose and lips without much visible scars on the face

Postoperative profile view following 1 week after suture removal showing enhanced appearance

Columellar view showing corrected dorsum and alar shape with defined columella of nose

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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 cleft nose and lip correction with Abbe flap

25/3/2015

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A 22 year old girl born with bilateral cleft lip and palate came to our hospital for expert cleft treatment. She was operated elsewhere for primary cleft lip and palate. She had a thin upper lip and broad flattened nose for which she 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 is 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.

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

Costochondral rib graft harvested to reconstruct the defective cleft nose

Immediately after suturing

Immediately after 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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Combined jaw correction & lip and nose defect correction with Abbe flap technique & rehabilitation with implants for bilateral cleft lip & palate

10/11/2014

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A 19-year-old boy reported to our hospital seeking to correct his nose, lip and jaw defect and to replace his missing upper front teeth. He was previously operated for bilateral cleft lip and palate elsewhere where his entire premaxilla was removed. His upper lip was very thin in the middle, his lower jaw was severely protruding and his nose defect affected his facial profile giving an unpleasant appearance. Also because of his missing upper front teeth he was unable to bite and eat properly.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined jaw, lip and nose correction. An Obwegeser’s bilateral sagittal split osteotomy was done reshaping the lower jaw bone and bringing it into proper alignment with the upper jaw. Dental implants were placed in the upper jaw to replace the missing teeth. In the Abbe flap technique, a flap of tissue was taken from the lower lip, rotated across the mouth and sutured together with the thin 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 proper moustache growth. After 3 weeks the flap was divided giving the upper lip a normal form and function. Ceramic crowns were fixed to the implants. Following complete rehabilitation, his appearance and self-confidence improved greatly and he is very happy with the results.

Preoperative facial view showing defective cleft lip and nose due to bilateral cleft defect

Preoperative intraoral view showing incorrect bite due to removal of premaxilla leading to missing teeth in upper front region of jaw

Reconstructed columella and shape of the ala of the nose by Abbe flap technique

Immediate postoperative view showing corrected bite by following Obwegeser's bilateral sagittal split osteotomy in mandible and lip revision by Abbe flap

Postoperative image showing corrected bite and missing teeth replacement with dental implant prosthesis

Postoperative facial view showing corrected lips, nose and missing teeth replacement giving enhanced appearance

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Combined nose and lip correction for Bangladeshi man with cleft lip & palate

13/10/2014

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A 30-year-old man from Bangladesh reported to our hospital seeking to correct his nose and lip defect to improve his appearance. He was previously undergone multiple surgeries elsewhere for his cleft defects. His nose appeared deviated to the left side, his nostrils appeared collapsed and his upper lip was short and thin that gave him an unattractive appearance.

Maxillofacial Surgeon Dr. S.M. Balaji successfully performed a combined correction of the nose & lip defect. The nasal septal deviation was corrected. Dome binding sutures were strategically placed to narrow the lower lateral nasal cartilage, thus making the nose tip less bulbous. The nostrils were reshaped and this enhanced the appearance of the nose instantly.

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.