Our Summary

This research paper discusses the method of cleft lip repair known as the anatomical subunit approximation. This method, developed by Dr. David Fisher, is designed to create a balanced, natural-looking contour of the lip, with the surgical scar hidden along the natural lines of the lip. The authors of the paper highlight a few key principles behind this technique.

Firstly, it’s important to plan the surgery according to the natural divisions or ‘subunits’ of the lip and to make very precise measurements. Secondly, it’s crucial to carefully separate each layer of tissue in the cleft (or gap) from the lip and nose, in order to restore balance. Thirdly, the surgery involves carefully positioning the muscles and skin of the lip, with a special technique used to close the skin above the ‘white roll’ (the edge of the lip).

The authors explain these principles not just to describe how the surgery is done, but to help teach others this technique. They believe that understanding these principles is key to mastering this method of cleft lip repair.

FAQs

  1. What is the advantage of the anatomical subunit approximation cleft lip repair technique?
  2. What are the key principles of the anatomical subunit technique in cleft lip repair?
  3. How does the anatomical subunit technique achieve a balanced lip contour in cleft lip repair?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft lip repair is to follow post-operative care instructions carefully to ensure proper healing and optimal results. This may include keeping the surgical site clean, avoiding activities that could put stress on the repair, and attending follow-up appointments with the surgeon to monitor progress. Additionally, maintaining good overall health and nutrition can also aid in the healing process.

Suitable For

Patients with cleft lip deformities, whether unilateral or bilateral, are typically recommended cleft lip repair. This technique is particularly beneficial for patients who desire a more balanced lip contour and improved aesthetic appearance. It is important for patients to be in good overall health and have realistic expectations about the outcome of the surgery. Patients with cleft lip deformities may also benefit from additional surgeries or treatments to address any associated issues, such as cleft palate repair or speech therapy.

Timeline

Before cleft lip repair:

  • Patient is evaluated by a team of healthcare professionals, including a plastic surgeon, to determine the best course of treatment
  • Preoperative appointments are scheduled for medical history, physical examination, and discussion of the procedure
  • Patient may undergo additional testing, such as blood work or imaging, to ensure they are healthy for surgery
  • Patient and family are educated on what to expect before, during, and after the procedure

After cleft lip repair:

  • Patient is monitored closely in the recovery room for any immediate complications
  • Patient may experience swelling, bruising, and discomfort in the days following surgery
  • Follow-up appointments are scheduled to monitor healing and remove any sutures
  • Patient and family are provided with instructions on how to care for the surgical site and manage pain
  • Long-term follow-up appointments are scheduled to monitor growth and development of the repaired lip

Overall, the goal of cleft lip repair is to achieve a balanced and aesthetically pleasing lip contour, while also improving function and speech for the patient.

What to Ask Your Doctor

  1. What is the expected outcome of the cleft lip repair surgery?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery period and what can I expect during the healing process?
  4. Will there be any visible scarring after the surgery and how can it be minimized?
  5. Are there any long-term effects or considerations I should be aware of after the surgery?
  6. How experienced are you in performing cleft lip repair surgeries?
  7. Are there any alternative treatment options available for cleft lip repair?
  8. What type of anesthesia will be used during the surgery and are there any risks associated with it?
  9. Will there be a need for additional surgeries or follow-up procedures in the future?
  10. What steps can I take to ensure the best possible outcome for the cleft lip repair surgery?

Reference

Authors: Chong DK, Swanson JW. Journal: Plast Reconstr Surg. 2016 Jul;138(1):91e-94e. doi: 10.1097/PRS.0000000000002257. PMID: 27348690