Bilateral Cleft Lip Repair

Mark the landmarks on the filtrum. As the filtrum should be no wider than 4 mm, you choose filtrum right and left, 2 mm on both sides next to the middle. These last landmarks should be just above the border between the wet and dry part of the lip. The white roll will be brought in from the side under the filtrum. Therefore, you mark one landmark just over and the other just under the white roll. Then 2 mm laterally from there, landmark number 16 on the other side, and of the white roll landmarks number 15 and 15 accent, and 2 mm lateral number 17.

Indicate, now as an Eingangschwelle, number 5 and 13. They represent the end of the medial cross of the lower lateral carglages. Measure the distance from 5 to 2, which is the length of the filtrum, and transpose it from 16 to find landmark number 9. Do the same on the other side from 13 to 3 and transpose it coming from 17 to find landmark number 14. Number 14 will later on be sutured to the Nasi-Eingangschwelle. The A-lar base, which is the end of the light reflection on the nostril,

now measure 4 to 9, which distance represents the width of the nostril postoperative. It should be symmetrical of course, so the same distance on the other side. To find the wet dry border, pinch the lip and on the highest profile on both sides draw a line with metal and blue. Now measure the distance from the wet dry border to the bromelian border. As you want symmetrical volumes of the lip, transpose this distance to the other side. Ideally landmark A should be on the wet dry border, but here this is not possible if you want symmetrical lips.

Infiltration of the lip and nose with loka and stezia mixed with adrenaline. To enlarge dimension and prevent bleeding of the superior lip atri pump, the lips are quite firmly with 2 to 3 ctl. For good vasoconstriction, wait 5 to 10 minutes. Use this time to make your cutting design by connecting the landmark and marks with metal and blue from the nose and eye-gown-schwelle down to number 2 and on the other side to make the design for the filter. It should be not too wide, try to draw these lines parallel.

Then from 17 up to 14, this is the top of the vestibule and put the tattoo on there. From landmark 9 to 16, crossing the right row, going down to landmark A, same on the other side. From the middle of the filter down to the top of the vestibule, from A also to the top of the vestibule, same on the other side. In the mid triangular flap should remain. Note that this is a partial cleft. Now design the dog ear flap, which has to be excised. In the highest landmark of this flap, it needs to be tattooed.