A Novel Surgical Technique for Bilateral Reconstruction of the Philtrum and Cupid's Bow in Secondary Unilateral Cleft Lip Deformities.

Abstract

Background: Secondary deformities involving the philtrum and Cupid's bow often persist in cleft lip and palate patients, leading to compromised aesthetic outcomes. This study aimed to evaluate a novel bilateral surgical approach for addressing unilateral secondary cleft lip deformities and improving philtral column and Cupid's bow prominence.

Materials and methods: This study included 16 patients with unilateral cleft lip deformities who underwent this procedure from June 2018 to June 2024, with a mean follow-up of 12 months (range 6-36). Three-dimensional stereophotogrammetry was used to assess philtral projection and lip height before and after surgery. Expert evaluations and patient satisfaction scores were collected.

Results: Three-dimensional measurements revealed significant improvements in philtral column and Cupid's bow projection, with reduced asymmetry (P < 0.01). Both sides of the philtrum exhibited enhanced projections, reducing side-to-side differences (P < 0.01), and philtrum height increased on the cleft side (P = 0.017), demonstrating enhanced symmetry. Expert assessments yielded an average overall score of 4.2, indicating a generally "satisfactory" postoperative outcome. Patient-reported satisfaction was 3.1 out of 4.

Conclusions: This technique innovatively introduces the concept of bilateral surgical correction to address secondary unilateral cleft lip deformities. Enhanced symmetry, high patient satisfaction, and minimal complications underscore its potential to safely achieve refined, balanced upper lip contours.