Dermal Roll flap for alar base support

Background: Unilateral secondary cleft lip and nasal deformity is almost always associated with under projected cleft side alar base for which augmentation with autologous grafts or synthetic material has been described. Many of such cases with secondary cleft lip and nasal deformity require revision surgery for wide lip scar or vermillion disparities. Objective: During lip revision surgery, some vascularized lip tissue can be spared in the area of previous repair and can be utilized as dermal roll flap for augmentation of alar base. Methodology: This prospective study was conducted on forty-three patients requiring lip scar revision with unilateral secondary cleft lip and nasal deformity having difference of alar base projection of 2 to 5mm measured on basal view photograph. Dermal roll flap was marked, de-epithelized and incised. Tunnel under the alar base was made, insetting of flap was done and lip repair completed. Measurements repeated after 6 months to find out improvement in the projection.

Inclusion Criteria:

• Secondary cleft lip and nasal deformity with wide lip scar need revision

Exclusion Criteria:

• Bilateral cleft lip secondary deformity