Aesthetic Enhancement of the Vermilion Using Dermofat Graft in Patients With Cleft Lip Deformity

2021 ◽  
pp. 105566562110017
Author(s):  
Kyung Hoon Chung ◽  
Karel A. deLeeuw ◽  
Hsiu-Hsia Lin ◽  
Lun-Jou Lo
Keyword(s):  
Cleft Lip ◽  
Qualitative Assessment ◽  
Patient Questionnaire ◽  
Upper Lip ◽  
Lower Lip ◽  
Quantitative Image ◽  
Dermofat Graft ◽  
Reproducible Method ◽  
The Mean

Background:There is an increasing patient expectation for better esthetics, manifesting through anatomical harmony, projection, and volume of the upper lip relative to the lower lip, in patients with cleft deformity. The aim of this study is to investigate the outcome of vermilion augmentation using autologous dermofat graft (DFG) to enhance the lip using both quantitative and qualitative assessment.Methods:Patients with secondary cleft lip deformity who received the surgical treatment in our institution from 2015 to 2018 were recruited. Panel assessment was performed on standardized preoperative and postoperative digital photographs. A patient questionnaire was used for the reported outcome. Image processing and analyses were applied to measure the lip change. Statistical analyses were performed.Results:A total of 91 patients were included. The mean age at operation was 22.7 years, and postoperative follow-up was 3.6 years. There were no complications in the study group. The panel assessment showed significant improvement ( P < .00001) on upper lip vermilion in both frontal and lateral profile views. Ninety-five percent of patients reported improvement of the upper lip projection and volume. Quantitative image analysis showed an increase in the upper lip vermilion ratio in 97% of the cases in frontal views and improvement of the vermilion projection in 87% of the cases in the superimposed lateral views.Conclusions:The use of DFG is an effective and reproducible method for vermilion augmentation and aesthetic enhancement in patients presenting with upper lip insufficiency relative to the lower lip.

scholarly journals Evaluation of long-term sagittal lip changes using Burstone line: Pilot Study

2021 ◽  
Vol 7 (2) ◽  
pp. 32-37
Author(s):  
Rachel Sathekge ◽  
Colin Lesar
Keyword(s):  
Soft Tissue ◽  
Upper Lip ◽  
Short Term ◽  
Time Intervals ◽  
Lower Lip ◽  
Linear Distance ◽  
Long Term Follow Up ◽  
The Mean

Objective Lip position has become one of the most important soft tissue analyses as it influences the occlusion, tooth stability and facial aesthetic. Hence, the objective of this study was to compare the short-term and long-term sagittal lip positions/changes using the Burstone line (B-line).   Methods The sample consisted of 18 Caucasoid females only (14 extractions, 4 non-extractions) who were successfully treated with edgewise appliances. All the patients were evaluated before treatment (T1),at the end of active treatment (T2), and at a long-term follow-up observation (T3). The mean age at commencement was 13.2 years with the range of 10.5-19 years. The linear distance between the tip of the lips and the B-line were measured.   Results T1-T2 time intervals showed the upper lip underwent a mean change of 1.272 mm relative to the B-line (-32.8%) which was statistically significant. The lower lip showed a mean change of 1.549 mm (-22.2%), but these changes were not statistically significant. Lip protrusion relative to the B-line continued to reduce during the long term follow up period. The upper lip showed slight changes (-9.2%), whereas the lower lip demonstrated greater change (-53.8%).   Conclusion Using B-line, the sagittal soft tissue lip positions were more retrusive on the long-term follow-up records for both extraction and non-extraction cases, their values were not very different from the normal values of the untreated cases. Although the differences were not statistically significant,  upper lips were retrusive post treatment from T1-T2, while were statistically significant the lower lips were retrusive from T1-T2.

scholarly journals Evaluation of Lip Morphology and Nasolabial Angle in Non-Syndromic Cleft Lip and/Palate and Non-Cleft Individuals

2021 ◽  
Vol 12 (1) ◽  
pp. 357
Author(s):  
Mohammad Khursheed Alam ◽  
Ahmed Ali Alfawzan ◽  
Fatema Akhter ◽  
Haytham Jamil Alswairki ◽  
Prabhat Kumar Chaudhari
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Upper Lip ◽  
Lateral Cephalogram ◽  
Lower Lip ◽  
Nasolabial Angle ◽  
Bilateral Cleft Lip ◽  
Different Types ◽  
The Mean ◽  
Two Parameters

Objective: To investigate the variation between the non-syndromic cleft lip and/or palate (NSCLP) and non-cleft (NC) subjects in relation to the lip morphology (LM) and nasolabial angle (NLA). Materials and Methods: Lateral cephalogram (Late. Ceph.) of 123 individuals (92 NSCLP [29 = bilateral cleft lip and palate (BCLP), 41 = unilateral cleft lip and palate (UCLP), 9 = unilateral cleft lip and alveolus (UCLA), 13 = unilateral cleft lip (UCL)], and 31 NC) who did not undergo any orthodontic treatment were investigated. By WebCeph, an artificial intelligence- (A.I.) driven software, 2 (two) parameters of LM, namely upper lip to E line (LM-1) and lower lip to E line (LM-2), and NLA analysis was carried out for each individual. Multiple tests were carried out for statistical analysis. Results: The mean ± SD observed for LM-1, LM-2, and NLA for NC individuals were 1.56 ± 2.98, 0.49 ± 3.51, and 97.20 ± 16.10, respectively. On the other hand, the mean ± SD of LM-1, LM-2, and NLA for NSCLP individuals were 4.55 ± 4.23, 1.68 ± 2.82, and 82.02 ± 14.66, respectively. No significant variation was observed with respect to gender and side. NSCLP (different types) and NC individuals showed significant disparities in LM-1 and NLA. Conclusion: It can be concluded that parameters of lip morphology such as LM-1, LM-2, and NLA vary among NSCLP and NC individuals.

A Cephalometric Evaluation of Lower Lip in Patients with Unilateral Cleft Lip and Palate

2004 ◽  
Vol 41 (5) ◽  
pp. 485-489 ◽  
Author(s):  
T. Ufuk Toygar ◽  
M. Okan Akçam ◽  
Ayça Arman
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Normal Subjects ◽  
Middle Part ◽  
Class I ◽  
Control Group ◽  
Upper Lip ◽  
Lower Lip ◽  
Normal Individuals ◽  
Lateral Cephalograms

Objective The aim of this study was to evaluate cephalometrically the lower lip position and area of patients with unilateral cleft lip and palate (UCLP) comparatively with Class I skeletodental normal subjects. Patients Lateral cephalometric and hand-wrist radiographs obtained from 24 patients with UCLP (mean age 12.86 years), along with 20 normal individuals (mean age 12.33 years) used as a control group, were examined. Design In addition to standard cephalometric dentofacial variables, lower lip area (superior, middle, inferior) was also measured using a digital planimeter on the lateral cephalograms. Results The superior and middle part of the lower lip areas were significantly smaller (p < .05) in the UCLP group, compared to the control group. The inferior and total lower lip areas of patients with UCLP were found to be significantly smaller than controls. The labiomental angle was also smaller (38.79 degrees). Conclusions The results suggest that the lower lip of patients with UCLP is smaller, retruded, and curved, with a deep labiomental sulcus, compared with normal individuals during puberty. Therefore, practitioners should focus not only on the upper lip of patients with UCLP but also should consider the lower lip as it was found distinct from normal individuals during puberty.

scholarly journals Secondary bilateral cleft lip-nose deformity correction by rhinoplasty with simultaneous Abbe flap

2014 ◽  
Vol 47 (01) ◽  
pp. 20-24 ◽  
Author(s):  
Nitin J. Mokal ◽  
Manpreet Juneja
Keyword(s):  
Cleft Lip ◽  
Perioperative Complications ◽  
Deformity Correction ◽  
Flap Necrosis ◽  
Upper Lip ◽  
Bilateral Cleft Lip ◽  
Nose Deformity ◽  
Abbé Flap ◽  
Cleft Lip Nose

ABSTRACTAim: The purpose of this article is to review modification and outcome of secondary rhinoplasty along with Abbι flap for correction of secondary bilateral cleft lip deformity. Materials and Methods: A total of thirteen patients of secondary bilateral cleft lip-nose deformity having tight upper lip, lack of acceptable philtral column, Cupid′s bow definition, irregular lip scars, and associated nasal deformity were selected. All the patients received Abbι flap and simultaneous nasal correction. All cases were treated during a period of three years. Mean patient age at the time of the operation was 21 years, and ranged from 16 to 27 years. The average follow-up period was three years. Results: Assessment of results was based on comparing preoperative and postoperative clinical photographs done by surgeon and patient relatives and patient satisfaction questionnaires. The columellar lengthening and upper lip vermillion correction achieved was satisfactory. There were no perioperative complications such as airway obstruction, bleeding, infection, wound disruption, or flap necrosis.

The Lambda Flap for Secondary Cleft Lip Repair

1997 ◽  
Vol 34 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Ichiro Tange
Keyword(s):  
Cleft Lip ◽  
Donor Site ◽  
Skin Surface ◽  
Upper Lip ◽  
Lower Lip ◽  
Cleft Lip Repair ◽  
Technical Details ◽  
Abbé Flap ◽  
Figure Type

Objective: A modified Abbe flap of the lambda figure type, designed by the author and used before or after secondary cleft lip repair in 146 consecutive cases since 1990 is described. Design: This series consisted of 71 cases with unilateral deformity and 75 cases with bilateral deformity at adolescent or adult ages. The technical details of this method and representative cases with the results are shown. The philtrum is created by incising the two branches of the lambda flap obliquely at 45 degrees to the skin surface in the lower lip, then matching them in the central recipient bed of the deficient upper lip. Results and Conclusions: The resultant upper lip is not only full and slack, but also attractive with an acute cubic contour of the philtrum. Furthermore, the residual scar at the donor site is concealed in the mentolabial fold.

scholarly journals Photoanthropometry in forensics: Comparison of facial images with frontal and lateral views

2021 ◽  
Vol 10 (5) ◽  
pp. e27610514795
Author(s):  
Tainá Nascimento Falcão ◽  
Yanka Barbosa Alves ◽  
Lidiane Gonçalves do Nascimento ◽  
Rachel Lima Ribeiro Tinoco ◽  
Laíse Nascimento Correia Lima ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Upper Lip ◽  
Lower Lip ◽  
Facial Analysis ◽  
Kolmogorov Smirnov ◽  
Facial Proportions ◽  
The Mean ◽  
Analysis System ◽  
Facial Images ◽  
Smirnov Test

Photoanthropometry quantify the facial proportions of an individual facilitating the comparison of facial patterns for human identification. The coordinates and vertical distances in pixels of the photoanthropometric landmarks on images of the same individual in frontal and profile views were analyzed and compared. A total of 116 pairs of photographs of Brazilian individuals were evaluated. The photographs were adjusted in size and rotation, and marked in the software Two-dimensional Forensic Facial Analysis System. For each face, 16 landmarks were considered: glabella (g), nasion (n), ectocanthion (ec), pronasale (prn), subnasale (sn), alare (al), cheilion (ch), upper lip (ls), lower lip (li), stomion (sto), labiomental (lm), gnathion (gn), superaurale (sa), subaurale (sba), postaurale (pa) and upper ear lobe (slb); the x- and y-coordinates of each landmark were obtained. Twenty-seven vertical distances between the points were proposed, which were measured by subtracting the values of the y-coordinate. The data were analyzed descriptively and inferentially using the Kolmogorov-Smirnov test, intraclass correlation coefficient (ICC) and Mann-Whitney test (α=5%). The mean age of the sample was 25.9 years (± 4.7), and 50.9% (n=59) were males. When the coordinates were evaluated, a low correlation was obtained between the images (ICC<0.4). Of the 27 proposed measures, 77.7% (n=21) indicated agreement between the images in the two views (p>0.05). A comparison of ls-g, sa-ec, pa-ec, slb-ec, sba-sa and slb-sa showed disagreement between the images. Therefore, there is agreement between the facial measures in the frontal and lateral images, except for ls-g and for the distances between the ear landmarks.

Avaliação do potencial de modifcação labial do ácido hialurônico em pacientes reabilitados com próteses híbridas implantossuportadas de maxilas totais

2020 ◽  
Vol 2 (5) ◽  
pp. 48-62
Author(s):  
Marcelo Luis Samistraro Turella ◽  
Marcos André Duarte da Silva ◽  
Isabela Almeida Shimizu ◽  
Ivete Aparecida Mattias Sartori ◽  
Ricarda Duarte da Silva
Keyword(s):  
Hyaluronic Acid ◽  
Self Esteem ◽  
Inclusion Criteria ◽  
Upper Lip ◽  
Lower Lip ◽  
Before And After ◽  
Degree Of Satisfaction ◽  
Angular Measurements ◽  
Fixed Prosthesis ◽  
The Mean

Understanding the problem of upper arches rehabilitation with implants in relation to the complain of lack of lip support, this study was designed to assess the potential of hyaluronic acid (HA) to increase lips volume and to fill the nasogenian groove in this group of patients. One hundred patients with rehabilitated maxilla with implant-supported hybrid fixed total prosthesis were selected. Of these, 86 attended the initial consultation and eight individuals were included in the study. The sample inclusion criteria were use of implant-supported fixed prosthesis in the maxilla with complaint of thin lips and deepening of the nasogenian groove and patients who agreed to participate of the study. Linear and angular measurements were drawn on initial an after procedure teleradiographies in order to assess lip protrusion before and after hyaluronic acid filling. Also standardized photographs were taken before and after the procedures, which were assessed by dentists and lay people. The participants of the study answered a questionnaire in order to assess the degree of satisfaction with the procedure. Hyaluronic acid filling presented significant differences (t1-t2) for upper and lower lip protrusion p= 0.001 and p=0.02, respectively. For the upper lip, the mean protrusion was 0.76mm + 1.88 (t1) before the filling with hyaluronic acid procedure and after filling the mean protrusion was 3.45mm + 1.58 (t2). Independent evaluators and practitioners assessed the facial profiles after the filling with HA, mostly as medium and significant better alterations. It can be concluded that lip and nasogenian sulcus filling in individuals rehabilitated with implant-supported total fixed implants increased self-esteem and provided close to normal lip protrusion.

scholarly journals Cable plating with a single strut allograft in the treatment of periprosthetic fractures of the femur

2018 ◽  
Vol 29 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Jonathan R Manara ◽  
John A Mathews ◽  
Harvey S Sandhu
Keyword(s):  
Plate Fixation ◽  
Periprosthetic Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Reproducible Method ◽  
The Mean ◽  
Modified Harris Hip Score ◽  
Unified Classification System ◽  
Hip Arthroplasties

Background: Hip arthroplasties are increasing worldwide resulting in an increasing number of periprosthetic fractures. These fractures are difficult to treat with various the different fixation or revision options described, many of which have high complication rates. Purpose: To investigate whether our described method of treating periprosthetic fractures is an effective, safe and reproducible method of treating patients. Methods: We describe the largest series of a cable plate fixation system combined with a single cortical strut allograft to treat patients with periprosthetic fractures of the hip (Unified Classification System B1 and selected B2, C and D). Results: Between July 2006 and March 2015, 28 patients were treated using this method. The mean follow-up was 2.2 years (3 months to 9 years). The mean Oxford Hip Score (OHS) at final follow-up was 32 and the mean modified Harris Hip Score (mHHS) 67. There were 3 complications including 1 failure that required revision surgery, 1 case of infection successfully treated with debridement, antibiotics and retention, and a case of discomfort from the metalwork which we managed conservatively. Conclusion: This method of anatomical restoration of the femur with dual-plane fixation is a highly effective method of treating this complex group of patients, and should be considered as a first line of treatment. It shows that there is a role for successful treatment with internal fixation of certain B2, C and D fractures with this technique.

scholarly journals Posterior corrective surgery with a multilevel transforaminal lumbar interbody fusion and a rod rotation maneuver for patients with degenerative lumbar kyphoscoliosis

2017 ◽  
Vol 26 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Akira Matsumura ◽  
Takashi Namikawa ◽  
Minori Kato ◽  
Tomonori Ozaki ◽  
Yusuke Hori ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Ct Imaging ◽  
Patient Questionnaire ◽  
Lumbar Interbody Fusion ◽  
Corrective Surgery ◽  
Sf 36 ◽  
Scoliosis Correction ◽  
The Mean

The purpose of this study was to assess the clinical results of posterior corrective surgery using a multilevel transforaminal lumbar interbody fusion (TLIF) with a rod rotation (RR) and to evaluate the segmental corrective effect of a TLIF using CT imaging. The medical records of 15 consecutive patients with degenerative lumbar kyphoscoliosis (DLKS) who had undergone posterior spinal corrective surgery using a multilevel TLIF with an RR technique and who had a minimum follow-up of 2 years were retrospectively reviewed. Radiographic parameters were evaluated using plain radiographs, and segmental correction was evaluated using CT imaging. Clinical outcomes were evaluated with the Scoliosis Research Society Patient Questionnaire-22 (SRS-22) and the SF-36. The mean follow-up period was 46.7 months, and the mean age at the time of surgery was 60.7 years. The mean total SRS-22 score was 2.9 before surgery and significantly improved to 4.0 at the latest follow-up. The physical functioning, role functioning (physical), and social functioning subcategories of the SF-36 were generally improved at the latest follow-up, although the changes in these scores were not statistically significant. The bodily pain, vitality, and mental health subcategories were significantly improved at the latest follow-up (p < 0.05). Three complications occurred in 3 patients (20%). The Cobb angle of the lumbar curve was reduced to 20.3° after surgery. The overall correction rate was 66.4%. The pelvic incidence–lumbar lordosis (preoperative/postoperative = 31.5°/4.3°), pelvic tilt (29.2°/18.9°), and sagittal vertical axis (78.3/27.6 mm) were improved after surgery and remained so throughout the follow-up. Computed tomography image analysis suggested that a 1-level TLIF can result in 10.9° of scoliosis correction and 6.8° of lordosis. Posterior corrective surgery using a multilevel TLIF with an RR on patients with DLKS can provide effective correction in the coronal plane but allows only limited sagittal correction.

Bipedicled Axial Cross-lip Flap for Correction of Major Vermilion Deficiency after Cleft Lip Repair

1994 ◽  
Vol 31 (2) ◽  
pp. 148-151 ◽  
Author(s):  
Jeffrey D. Wagner ◽  
M. Haskell Newman
Keyword(s):  
Coronary Arteries ◽  
Cleft Lip ◽  
Local Flaps ◽  
Upper Lip ◽  
Lower Lip ◽  
Mucosal Flap ◽  
Second Stage ◽  
Cleft Lip Repair

Vermilion irregularities are common secondary deformities after cleft lip repair. Particularly severe In bilateral clefts, vermilion deficiency attracts considerable attention and detracts from an otherwise excellent lip repair. Minor and moderate vermilion deficits can be corrected with upper lip advancement, rotation flaps, tongue flaps, or grafts. Major defects defy correction with local flaps, because of an absolute shortage of upper-lip tissue. A technique Is described for correction of large absolute tissue deficits of the upper-lip vermilion using a bipedicled lower to upper cross-lip visor flap. A lower lip wet vermilion/mucosal flap is based bilaterally near the commissures on the coronary arteries and transferred to a releasing incision at the wet/dry vermilion border of the upper lip. The commissural pedicles are divided and inset at a second stage 10 days later to complete the transfer. The procedure provides ample bulk and lining for major upper-lip vermilion augmentation and tubercle reconstruction without disturbing the obicularis oris muscular oral sphincter. In addition it balances the lips and allows for feeding. The technique is illustrated In two patients with major upper-lip vermilion defects after repair of bilateral cleft lips.

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