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DISAIN LABIOPLASTY

The preoperative design of the surgical method is marked on the skin and the vermilion. A total
of 13 points are marked (points 0–12). The A flap, B flap, triangular flap, M (medial mucosal)
flap, and L (lateral mucosal) flap are designed.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The preoperative design of the surgical method is marked on the vermilion and the intraoral
mucosa.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The intraoperative photograph of the marking is shown. The patient was a 3-month-old male and
had a complete cleft lip on the left side.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
Dissection is performed to separate the orbicularis oris muscle from the abnormally inserted
neighboring structure and the enveloped skin-mucosal flap. The release and dissection below the
orbicularis oris muscle ranges from the cleft margin to the anterior nasal spine and piriform
aperture base on the noncleft side.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
On the cleft side, the release of the abnormally inserted muscle covers the pericleft and anterior
maxillary area.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The wide dissection and release of the orbicularis oris muscle are completed.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
After dissection on both sides of the cleft is completed, the orbicularis oris muscle is fully
detached from the abnormal insertions. The freed orbicularis oris muscle is then reconstructed.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The orbicularis oris muscle should be repaired with full width, from the columellar base to the
red vermilion.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The orbicularis oris muscle that was repaired with full width is shown, intraoperatively.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The M (medial mucosal) flap (above) and L (lateral mucosal) flap (below) are preserved and
sutured for covering the oronasal lining in the complete cleft lip patient. The positions of the M
and L flaps can be interchanged depending on the circumstances of the cleft defect.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
After all layers of the lip wound are closed, a straight vertical skin suture line is achieved without
any unnecessary transverse scar.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The straight-line wound closure was performed.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
The photographs of 3 patients before (A, C, and E) and 1 year after (B, D, and F) the StART are
presented. All patients were 3 months old at primary cheiloplasty. Patient 1 (A and B) was female
and had a complete cleft lip on her left side. Patient 2 (C and D) was male and had a complete
cleft lip on his right side. Patient 3 (E and F) was female and had a complete cleft lip on her left
side.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique
An unnatural white roll line with an acute angulation at the Cupid’s bow may occur without a
small triangular flap design.

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Practical Repair Method for Unilateral Cleft Lips: Straight-Line Advanced Release Technique