What Are the Different Techniques for Cleft Lip Repair?
Several surgical techniques exist for repairing cleft lips. Here is an overview of the most common approaches.
Cleft lip repair techniques have evolved significantly. The goal is to create a natural-looking lip with proper function and minimal scarring.
Unilateral cleft lip techniques:
- Millard Rotation-Advancement (most common):
- The medial (inner) side of the cleft is "rotated" downward
- The lateral (outer) side is "advanced" inward
- The scar follows the natural line of the philtral column
- Excellent for most unilateral clefts
- Mohler Technique:
- A modification of the Millard
- The incision extends onto the non-cleft side of the lip
- Better for wider clefts
- Provides more length to the repaired lip
- Tennison-Randall (triangular flap):
- A small triangular flap from the lateral lip is placed into an incision on the medial side
- Adds length to the lip
- Good for moderate clefts
- Fisher Technique:
- A modern, geometric approach
- Very precise measurements and markings
- Produces excellent symmetry
- Gaining popularity among cleft surgeons
Bilateral cleft lip techniques:
- Mulliken Technique:
- Addresses both sides and the central lip
- Often done in two stages
- Preserves the central lip tissue
- Creates a natural Cupid's bow
- How surgeons choose:
- Type and width of the cleft
- Surgeon's training and preference
- Tissue quality and availability
- Desired outcome
Clinical Guidance
The most common cleft lip repair technique is the Millard rotation-advancement. Modern techniques like the Fisher method are gaining popularity. The best technique is the one that your cleft surgeon is most experienced with for your child's specific type of cleft.