We describe a modification of Goldstein's technique for secondary lip repair in patients with cleft lip and palate and report the outcome in 20 patients. Many patients with cleft lip have a small amount of upper lip tissue as compared with the lower lip, causing the lips to be unbalanced. Previously, we used Abbe's flap technique for such unbalanced lips; however, this method has the disadvantage of leaving scar tissue in the lower white lip area, whereas our modification of Goldstein's method does not leave scars in either the white or dry lip areas. Further more, during the 10-day period before cutting the flap, the patients experienced less stress because they were able to move their lips slightly.
To perform our procedure, an approximately 7-mm-wide flap is designed inside the wet lower lip. An incision is made in the lower lip, excluding the angle of mouth, but including the labial artery. A median incision is made in the flap, and the flap is raised using the angle of the mouth as a pedicle. An incision is made in the upper wet lip, and the flap is transplanted to the upper lip. Finally, the pedicle of the flap is cut after approximately 10 days.
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