Free dermis—fat graft to correct the whistle deformity in patients with cleft lip  I.A Patel, P.N Hall  British Journal of Plastic Surgery  Volume 57, Issue 2, Pages 160-164 (March 2004) DOI: 10.1016/j.bjps.2003.11.007

Figure 1 Case I: a patient who had primary correction at 3 months, subsequent revision at 2 and 5 years. (1) Shows preop view. (2) Postop view at 1 year. Undercorrection due to inadequate graft and possible resorption. (3) Three months postop following a second dermis graft. (4) Eleven months postop the notch has smoothed out due to scar remodulation. (5) Thirteen months postop shows a full smile. Contrast with picture (1). (6) Worms eye view at two and half years postop. (7) Frontal view at two-and-half years. British Journal of Plastic Surgery 2004 57, 160-164DOI: (10.1016/j.bjps.2003.11.007)

Figure 1 Case I: a patient who had primary correction at 3 months, subsequent revision at 2 and 5 years. (1) Shows preop view. (2) Postop view at 1 year. Undercorrection due to inadequate graft and possible resorption. (3) Three months postop following a second dermis graft. (4) Eleven months postop the notch has smoothed out due to scar remodulation. (5) Thirteen months postop shows a full smile. Contrast with picture (1). (6) Worms eye view at two and half years postop. (7) Frontal view at two-and-half years. British Journal of Plastic Surgery 2004 57, 160-164DOI: (10.1016/j.bjps.2003.11.007)

Figure 2 Case II. (1) Bilateral cleft deformity, primary correction done at 6 months. He had several subsequent revisions including an Abbe flap. A V–Y plasty was done to lengthen the prolabium and a dermis fat graft was done to build the vermilion.(2) Postop result at 11 months follow-up. British Journal of Plastic Surgery 2004 57, 160-164DOI: (10.1016/j.bjps.2003.11.007)

Figure 3 Case III: operative series. (1) Preop. (2) Intraop picture showing a dermis fat graft being pulled through a subcutaneous tunnel. (3) Shows the graft in situ. Excess graft would be trimmed at the edges and incisions closed. A small Z-plasty at the vermilion completes the procedure. We do not always do the Z-plasty. British Journal of Plastic Surgery 2004 57, 160-164DOI: (10.1016/j.bjps.2003.11.007)