Novel Passage of Dermis-Fat Graft for Augmentation of Vermilion Deficiency Following Cleft Lip Repair

Daniel C. Sasson, Sergey Y. Turin, Arun K. Gosain*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Despite timely repair of cleft lip, secondary deformities such as vermilion notching or “whistle deformity” often require further surgical treatment. The use of dermis-fat graft for soft tissue augmentation of the upper lip is an established technique. We propose an innovation on this technique, by which the dermis-fat graft can be placed reliably and with minimal dissection by use of a soft red rubber sheath to protect the Keith needle while delivering the graft through the submucosal pocket in the dry vermilion, thereby avoiding the needle inadvertently catching soft tissue inside the pocket. We recommend using an 8F red rubber catheter, cutting the catheter to be just shorter than a 2.5-inch Keith needle. This provides a sheath through which the Keith needle can be passed within the submucosal vermilion tunnel. We believe this to be much more reliable for vermilion augmentation than other techniques, including fat injection, and makes graft inset more predictable, faster, and simpler.

Original languageEnglish (US)
Pages (from-to)919-922
Number of pages4
JournalCleft Palate-Craniofacial Journal
Volume57
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • lip form
  • lip function
  • pediatrics
  • surgical technique

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

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