Am I a good candidate for a cleft lip revision procedure to improve appearance?

Question

I had my last cleft lip repair surgery as a teenager 32 years ago. Now 47, I am wondering if I would be a good candidate for a revision. I would like to see my upper lip lowered enough so that my teeth are covered as much as possible. Also would like to reduce scarring if possible.

George Volpe, MD · Answer

Any plastic surgeon who is experienced in cleft lip surgery is also experienced in the revision of cleft lip surgeries. Improving the appearance of the vermilion which is the pink part of your lip can usually be achieved through a number of techniques. A good exam by your plastic surgeon can outline the various alternatives. Often this can be done under local anesthesia in the office to avoid a more costly and involved procedure under general anesthesia.

Christian L. Stallworth, MD · Answer

Thanks for your question and sharing your photos.  In my mind, you are certainly a good candidate for lip revision.  Please understand that you should seek consultation from an experienced cleft surgeon well versed in adults as well as pediatric patients.  There are a number of techniques that can improve your lip, and though you may have already had one based on your photos, I would seriously consider something called an Abbe Flap to correct your current lip configuration.Best of luck with your revision!

Devan Griner, MD · Answer

It appears that you would be an excellent candidate for a lip revision surgery. The type of repair that you had done looks like a Manchester repair which focuses on detail of the cupid’s bow part of the lip but does not bring the muscle all the way across the lip. This is often called a “whistle” deformity of the lip. Modern day repairs focus on bring the muscle together all the way which has an affect of lowering and evening the lip. Added bulk to the upper lip can be given by borrowing tissue from the lower lip with an Abbe flap. It appears that this may have been what was attempted on you as a teenager given the scar on your lower lip. You should seek out a board-certified plastic surgeon who specializes in cleft and craniofacial surgery and has experience with cleft lip revision surgery. A physical exam and a review of any records you can get would be very helpful. Good luck and stay #cleftproud!

Brooke French, MD, FACS · Answer

Hello and thank you for the question.  I agree with Dr. Ruotolo in that you may be a good candidate for an Abbe flap but it appears you have a lower lip scar that raises the question as to whether you have already had this.  The other techniques mentioned may be good options for you to complement your facial balance.  I recommend you have a consultation with a cleft and craniofacial surgeon.  Best of luck to you!

Jacqueline Wegge, MD · Answer

You are definitely a good candidate for a lip revision! There are many techniques that can be performed to improve the scarring and symmetry of your lip, as well as coverage of your upper teeth. This can include releasing scar tissue, borrowing tissue from inside the mouth, fat grafting and flaps which bring tissue in from the surrounding area and/or repositioning your natural lip tissue.  It appears as though you may have already had an abbe flap previously.  The best course of action would be to make an appointment with a plastic surgeon trained in craniofacial surgery.  After a good physical exam they would be able to explain all of your options and come up with a surgical plan.

Rachel A. Ruotolo, MD, FACS · Answer

Hi! Thank you for your question.  Yes, you are an excellent candidate for a lip revision. Your surgical options would depend upon which surgeries were performed in the past.  It is essential that you seek consultation with a board certified plastic surgeon that is experienced in cleft reconstruction. An Abbe flap is a good option for you, although based on your photos, this may have already been done.  Good luck with your consultation and revision!

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