THE PROLABIAL UNWINDING FLAP METHOD FOR ONE-STAGE REPAIR OF BILATERAL CLEFT-LIP, NOSE, AND ALVEOLUS

This paper describes a one-stage reconstruction of the complete bilateral cleft lip, nose, and alveolus using an asymmetrically designed prolabial flap. The columella of the nose and the central lip are produced by ''unwinding'' the columellar and labial sections of the prolabium around a small central tab, which is used to center the junction between the lip and columella. Only two scars are produced, both of which run vertically along each philtral column. Accurate preoperative orthopedics without lip adhesion is considered essential to this repair. The principal advantage/disadvantage to the method is its asymmetrical design. If asymmetries result, they have been easily corrected. Eight consecutive cases are presented with follow-up ranging from 1.5 to 6.3 years.