Maxillofac Plast Reconstr Surg.  2017 May;39(5):12. 10.1186/s40902-017-0109-1.

Modified Fisher method for unilateral cleft lip-report of cases

• Kim HY
• Park J
• Chang MC
• Song IS
• Seo BM

• KMID: 2400474
• DOI: http://doi.org/10.1186/s40902-017-0109-1

Abstract

BACKGROUND
Rehabilitation of normal function and form is essential in cleft lip repair. In 2005, Dr. David M. Fisher introduced an innovative method, named "an anatomical subunit approximation technique" in unilateral cleft lip repair. According to this method, circumferential incision along the columella on cleft side of the medial flap is continued to the planned top of the Cupid's bow in straight manner, which runs parallel to the unaffected philtral ridge. Usually, small inlet incision is needed to lengthen the medial flap. On lateral flap, small triangle just above the cutaneous roll is used to prevent unesthetic shortening of upper lip. This allows better continuity of the Cupid's bow and ideal distribution of tension.
CASE PRESENTATION
As a modification to original method, orbicularis oris muscle overlapping suture is applied to make the elevated philtral ridge. Concomitant primary rhinoplasty also results in good esthetic outcome with symmetric nostrils and correction of alar web. As satisfactory results were obtained in three incomplete and one complete unilateral cleft lip patients, indicating Fisher's method can be useful in cleft lip surgery with functional and esthetic outcome.
CONCLUSIONS
Clinically applied Fisher's method in unilateral cleft lip patients proved the effectiveness in improving the esthetic results with good symmetry. This method also applied with primary rhinoplasty.

Keyword

Cleft lip; Fisher; Orbicularis oris muscle; Primary rhinoplasty; Alar web correction

MeSH Terms

Bays
Cleft Lip
Humans
Lip
Methods*
Rehabilitation
Rhinoplasty
Sutures