Improved cosmetic and functional outcomes with V-shaped mini flap and dermofat graft combination for revision of cleft lip scars: A retrospective observational study

Cleft lip is a craniofacial anomaly, a developmental defect originating in the embryonic period. Cleft lip repair is most often performed between 3 and 6 months after birth. The scar that develops after repair is aesthetically and functionally improved through revision using various grafting techniques. The V-shaped mini-flap method is frequently used for the closure of mini-microform cleft lips. The aim of this study was to present the cosmetic and functional results. This was a retrospective observational study conducted from June 1, 2018 to June 30, 2024 including all patients who underwent secondary cleft lip revision. All patients had previously undergone primary cleft lip reconstruction, and all underwent revision for secondary cleft lip repair. A V-shaped mini flap was used to correct vermilion deviation, and a dermofat graft was used to prevent collapse. Some patients underwent simultaneous alveolar bone grafting. Numerical data were calculated by frequency analysis. The sample consisted of 30 patients who underwent secondary cleft lip revision. After primary cleft lip repair, whistling deformity occurred in 23.3% of the patients, vermilion irregularity in 26.7%, depression in 23.3%, pigmentation in 73.3%, and abnormal lip movements in 56.7%. Cleft lip was bilateral in 20% of patients and 40% had a history of concomitant cleft palate. Intraoperatively, 60% of the patients underwent V-shaped mini flap and 40% underwent V-shaped mini flap + alveolar bone graft. After secondary revision, hematoma developed in 6.7%, graft loss in 20%, and donor site morbidity in 13.4%, wound dehiscence, seroma in 10%, cyst formation in 6.7%, 10% of the patients were reoperated on. Secondary revision with a V-shaped mini flap or V-shaped mini flap + alveolar bone graft appears to be somewhat advantageous in correcting cosmetic and functional defects that arise after primary cleft lip repair, as it is associated with few manageable complications and may require a third cleft lip repair.