The use of Botulinum Toxin A in the surgical treatment of secondary cleft lip (secondary cheiloplasty): An objective and subjective evaluation of esthetic outcomes

The surgical correction of the cleft lip is a challenging one and obtaining consistently good esthetic outcomes sometimes can be elusive. Primary correction of cleft lip often results in secondary deformities requiring re intervention. Chemoimmobilsation with Botulinum Toxin A post-secondary cheiloplasty can help obtain favourable esthetic results. Aims: To evaluate the esthetic value of Botulinum Toxin A injection in secondary cleft lip surgeries and to assess the role of Botulinum toxin A in secondary cleft lip scars. Materials and Methods: 30 systemically healthy unilateral cleft lip patients reporting for secondary cheiloplasty procedure were taken up for the study. 10-12 units of Botulinum Toxin A was injected along pre-determined points on the lip. Objective (Photographic evaluation) and subjective (Patient questionnaire method) evaluation was carried out after one year post injection of Botulinum Toxin A. Results: Photographic evaluation revealed that the outcomes were mostly excellent or good. Subjective evaluation conducted showed that majority of patients were either happy or very happy with the esthetic results. Keywords: Botulinum Toxin A, cheiloplasty scars, esthetic evaluation, secondary cheiloplasty, secondary cleft lip, subjective evaluation, unilateral cleft lip.