Unit approach for vermilion repair in unilateral cleft surgery

In conventional unilateral cleft lip surgery the suture line proceeds from the philtral ridge to the vermilion in succession. However, when observed carefully, in a noncleft upper lip the existence of a whitish vertical line in the midline of the vermilion can be seen. Therefore we consider that the vermilion can be separated by the midline into two subunits. On the basis of this unit principle we placed the suture line in the vermilion at the midline in the repair of the unilateral cleft lip. This method has been performed in 14 cases of unilateral cleft lip since February 1994. The postoperative follow-up period ranges from 4 months to 7 years and 2 months. The suture line appears to almost correspond to the vertical line at the midline of the noncleft vermilion, thus resulting in a natural contour. Although the number of cases is still small, and the follow-up period is not long enough to draw positive conclusions, unilateral cleft lip surgery according to the unit principle is considered useful in making the scarring less conspicuous. © Springer-Verlag 2002.