The Triple Unilimb Z Plasty Technique for Severe Forms of Unilateral Cleft Lip Repair

BACKGROUND: A wide spectrum of variation of the unilateral cleft lip deformity requires an individualized management. Current classifications for unilateral cleft lip are limited to incomplete or complete, and these descriptions do not address well this deformity. The soft tissue deficiency is not considered, which plays an important role in the surgical correction of the unilateral cleft lip. The author developed an innovative technique for surgical correction of unilateral cleft lip with severe soft tissue deficiency. METHODS: Since 2007, 168 patients with severe unilateral cleft lip have been operated on by the author, using the proposed surgical technique. The author’s classification of severity considers a severe unilateral cleft lip as a discrepancy between the non-cleft and cleft vertical height greater than 6 mm. The technique uses 2 Z plasties for the upper lip and 1 Z plasty for vermillion repair. RESULTS: This method lets the surgeon to achieve an adequate symmetry of the upper lip. A low rate of revision (14.88%) has been observed for 13 years, using the proposed surgical technique, by the author. CONCLUSIONS: An innovative technique to address severe forms of unilateral cleft lip is presented in this article. This method represents a good alternative for cleft lips with increased lateral segment tissue deficiency, providing adequate lip symmetry.