Unilateral complete cleft lip repair: orthotopic positioning of skin flaps  Kyung Suck Koh, Joon Pio Hong  British Journal of Plastic Surgery  Volume 58, Issue 2, Pages 147-152 (March 2005) DOI: 10.1016/j.bjps.2004.10.006 Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions

Figure 1 An MR image of a normal philtral column (left). An MR image of a microform cleft lip (right). Note the symmetrical arrangements of the subcutaneous and muscular layer of the normal philtrum while the cleft patient's image shows a discontinuity of the subcutaneous structure on the cleft side lacking protrusion and definition of the philtral ridge. British Journal of Plastic Surgery 2005 58, 147-152DOI: (10.1016/j.bjps.2004.10.006) Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions

Figure 2 A 3-month-old female baby is seen with a complete cleft lip on the left side (above, left). Designs for surgical correction is made on the anticipated philtral ridge along the margins of the cleft and C flap (above, right). Note the C flap on the orthotopic position (center, left). After correction of all three layers (center-right). The schematic drawings are seen (below, left and right): Note the C-flap positioned orthotopically and the tip not rotated to point toward the back cut. British Journal of Plastic Surgery 2005 58, 147-152DOI: (10.1016/j.bjps.2004.10.006) Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions

Figure 3 A 3-month-old female baby is seen with complete unilateral cleft lip and without presurgical molding prior to surgery (above, left). The follow-up photo at 5 years shows a well-balanced upper lip with good philtral definition on the cleft side (above, right). Left oblique view (below, left) and right oblique view (below, right). British Journal of Plastic Surgery 2005 58, 147-152DOI: (10.1016/j.bjps.2004.10.006) Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions

Figure 4 A complete unilateral cleft lip with presurgical molding is seen at 2 months (above, right). One week after correction with noticeable scars are seen (above, right). Six months after correction (below, left). Five years after correction with well-balanced upper lip and good philtral definition (below, right). British Journal of Plastic Surgery 2005 58, 147-152DOI: (10.1016/j.bjps.2004.10.006) Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions

Figure 5 A unilateral cleft lip without presurgical molding is seen (left). Three years after correction. Note the well-balanced upper lip with good philtral definition (right). British Journal of Plastic Surgery 2005 58, 147-152DOI: (10.1016/j.bjps.2004.10.006) Copyright © 2004 The British Association of Plastic Surgeons Terms and Conditions