{"title":"Revisiting the Boot Flap for Secondary Repair of the Free Border in Cleft Lip.","authors":"Koichi Ueda, Yuka Hirota, Hiromi Kino, Chizuru Umeda, Daisuke Nishioka","doi":"10.1097/GOX.0000000000007107","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Deficiency of the free border of the lip and \"whistling lip\" deformity are encountered in secondary repairs of unilateral and bilateral cleft lip. We have reported the use of the de-epithelialized oral vestibular flap (boot flap) for secondary cleft lip repair. We experienced more cases using this method and analyzed them.</p><p><strong>Methods: </strong>Fifty-nine patients with a cleft lip underwent secondary repair using this method. In unilateral cases, total scores were determined by evaluating the height of the notch, the volume of the upper lip tubercle, and the upper lip volume of the cleft side. In bilateral cases, total scores were determined by evaluating the height of the notch and the volume of the median lip tubercle.</p><p><strong>Results: </strong>Of the 46 patients with a unilateral cleft lip, 3 patients underwent a second boot flap operation due to undercorrection, and 1 patient underwent boot flap revision. Of the 12 patients with a bilateral cleft lip, 1 patient underwent a second boot flap operation due to flap atrophy. The second operation could be performed without any difficulty in either unilateral or bilateral cases. Compared with the preoperative scores, the postoperative scores improved significantly in both unilateral and bilateral cases.</p><p><strong>Conclusions: </strong>We experienced a recurrent notch deformity after direct suturing in a patient with a unilateral cleft lip. This was thought to be caused by scar contracture. To prevent a recurrent deformity, it is important to interrupt the plane where scar contracture occurs by incorporating a boot flap and augmenting the volume.</p>","PeriodicalId":20149,"journal":{"name":"Plastic and Reconstructive Surgery Global Open","volume":"13 9","pages":"e7107"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456503/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and Reconstructive Surgery Global Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/GOX.0000000000007107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Deficiency of the free border of the lip and "whistling lip" deformity are encountered in secondary repairs of unilateral and bilateral cleft lip. We have reported the use of the de-epithelialized oral vestibular flap (boot flap) for secondary cleft lip repair. We experienced more cases using this method and analyzed them.
Methods: Fifty-nine patients with a cleft lip underwent secondary repair using this method. In unilateral cases, total scores were determined by evaluating the height of the notch, the volume of the upper lip tubercle, and the upper lip volume of the cleft side. In bilateral cases, total scores were determined by evaluating the height of the notch and the volume of the median lip tubercle.
Results: Of the 46 patients with a unilateral cleft lip, 3 patients underwent a second boot flap operation due to undercorrection, and 1 patient underwent boot flap revision. Of the 12 patients with a bilateral cleft lip, 1 patient underwent a second boot flap operation due to flap atrophy. The second operation could be performed without any difficulty in either unilateral or bilateral cases. Compared with the preoperative scores, the postoperative scores improved significantly in both unilateral and bilateral cases.
Conclusions: We experienced a recurrent notch deformity after direct suturing in a patient with a unilateral cleft lip. This was thought to be caused by scar contracture. To prevent a recurrent deformity, it is important to interrupt the plane where scar contracture occurs by incorporating a boot flap and augmenting the volume.
期刊介绍：
Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.
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