Unilateral Cleft Lip Repair

Abstract

The history of cleft surgery overrides the history of plastic surgery. The principles outlined for the manipulation of the soft tissues in patients with cleft lip and palate gradually evolved and integrated to the arsenal of principles of modern plastic surgery. The first surgical attempts to correct a cleft lip and palate date from 390 BC year in China, and were carried out with the approximation of the cleft margins (Boo 1966). In the early fourteenth century, Jehan Yperman was the first to describe in detail the primary unilateral and bilateral cheiloplasty (Millard 1976). In 1564, Ambroise Paré illustrated the procedure used to obtain a straight-line closure of cleft lip (Millard 1976) and subsequently wrote the principles of plastic surgery, stating that “surgery is an art” (Paré 1964). In 1597, Gaspar Tagliacozzi described with illustrations surgical steps of primary cheiloplasty (Gnudi and Wester 1976). In the eighteenth century, Lorenz Heister, in his treatise named “Chirurgie,” emphasized the need for delicate surgical instruments in the proper handling of cleft lip (Millard 1976). In 1843, Malgaigne described the primary cheiloplasty principles with local flaps, and in the following year, Mirault modified Malgaigne technique utilizing lateral segment flaps to establish length of the medial cleft segment (Malgaigne 1861; Mirault 1884).