Cupid’s Bow Leveling and Preservation of Lip Height and Width: A Modified Rotation-Advancement Technique

Abstract

Background: Several methods for cleft lip repair have been developed over time, with no clear method considered the standard. In the authors’ department, the use of a modified rotation-advancement technique rather than the traditional rotation-advancement technique in unilateral complete cleft lip repair has increased over the past decade. This study aimed to determine which technique provides better outcomes. Methods: This retrospective study was conducted by analyzing the preoperative and postoperative aesthetic nasal and labial anthropometric measurements of the frontal and basal views of 213 consecutive patients treated between October of 2013 and June of 2019. A total of 141 participants were treated with the traditional rotation-advancement technique, and 72 with the modified rotation-advancement technique. The inclusion criteria were nonsyndromic unilateral complete cleft lip repair with high-resolution, good-quality photographs; no presurgical nasoalveolar molding; no revision in the lip or nose areas; and at least 1 year of follow-up. Result: Patients who received the modified rotation-advancement technique had significantly improved Cupid’s bow position and orientation (P < 0.02 and P < 0.01, respectively) and enhanced vertical lip height symmetry (P < 0.01) while preserving the lip width. The columellar length (P < 0.03) and angulation (P < 0.045) were also significantly improved, with enhanced nostril inclination in this group (P < 0.06). Conclusions: According to the findings of the current study, modified rotation-advancement technique assisted surgeons in improving symmetrical leveling of the Cupid’s bow and significantly aided in correcting lip height without compromising lip width. Moreover, the modified rotation-advancement technique resulted in better aesthetic nasal outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.