title: An analysis of deformities in revision surgeries for secondary unilateral cleft lip.
abstract: OBJECTIVE
  To analyze the secondary cleft lip deformities and the possible causes in a cohort of cases.
  
  
  METHODS
  A case series.
  
  
  METHODS
  Services Institute of Medical Sciences and WAPDA Teaching Hospital Complex, Lahore, from September 2008 to March 2012.
  
  
  METHODS
  Consecutive cases of secondary unilateral cleft lip deformities were selected for the study. These cases were interviewed and deformities recorded. Pre and postoperative photographs were taken for comparison. Per operative photographs were taken, after marking of the incisions, to keep a record of the intervention needed to correct the deformities. These cases were then further analyzed to know the deformities and interventions needed for correction of these deformities.
  
  
  RESULTS
  Study subjects comprised 114 males and 75 females. Secondary correction was the most common in second decade of life with 82 cases in this group. The most common deformity was unfavorable scar in 150 cases followed by notch at the vermilion border in 124 cases. Short lip was found in 119 cases. Complete revision of the repair was required in 158 cases and 25 cases required partial redo of the initial repair. In other 6 cases, only scar revision was carried out.
  
  
  CONCLUSIONS
  Unfavorable scar followed by vermilion notch and short lip were the most common secondary cleft lip deformities. Better technique helps favorable scar. Vermilion notch and short lip can be overcome by switching from rotation advancement repair to the triangular flap repair of Noordhoff.
authors.affiliation: Department of Plastic and Reconstructive Surgery, WAPDA Teaching Hospital Complex, Lahore.
authors.forename: Saeed Ashraf
authors.initials: SA
authors.lastname: Cheema
authors.affiliation: Department of Plastic and Reconstructive Surgery, Faisal Hospital, Faisalabad.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Asim
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D002971:Cleft Lip / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008046:Lip / Q000002:abnormalities* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012086:Reoperation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult