⁠An “incomplete” cleft lip, meaning there is still a skin bridge, still requires full separation and dissection of the lip to fully repair the anatomy and minimize long-term asymmetries.
A few things I think about during this repair:

Pic 2 – The white roll (at the border between the skin and dry mucosa) draws attention if there is a break in that light reflex, so creating continuity with good quality white roll is priority number 1 to reduce unwanted attention.

Pic 3 – The muscle fibers not only need to be repaired, they must be reoriented back to their original direction. This is similar to what we have learned from our cleft palate repairs, as the muscle action has a vector that should be returned to normal anatomic direction as possible. Judicious backcuts help to unfurl the muscle and bring the noncleft side down.

Pic 5 – The septal deviation is due to the muscle imbalance, with the noncleft side muscle pulling unopposed. The septum here is straightened without any resetting or unseating of the cartilage; rather, it was achieved by balancing the forces on the septum by releasing the muscle on that side.

Pic 5 – The release of that muscle can be achieved underneath and separately from the skin, so that the scar on the surface stays along the philtral column without adding scar at the base of the columella if one chooses.

For more, visit our Cleft Lip Repair page or call us at (214) 241-1997.

💻 lawplasticsurgery.com
👨‍⚕️ Dr. Huay-Zong Law⁠
☎️ (214) 241-1997⁠
📍 Dallas, TX ⁠
📍 Plano, TX
🏥 Board-Certified Plastic Surgeon⁠
🎓 Craniofacial Fellowship Trained⁠ ⁠