Double Opposing Furlow’s Z plasty

Abstract

The double opposing Z plasty is an ingenious technique that applies a very basic plastic surgery principle to increase length along the diagonal of the “Z.” This technique can be efficiently utilized not only for primary palates but also for redo palates, where the muscle repair was not addressed. Its unique design avoids overlap of the nasal and the oral suture-lines, which may prevent fistula formation. Since the muscles are not stripped off, it will ensure that the scarring is minimum and the muscle function returns very early after the operation. It is a challenging procedure, however, and needs time to master. It may have limited use in wide palates, without the use of lateral releasing incisions or buccal flaps to aid in closure. This chapter highlights the simplest ways to avoid all the pitfalls and ensure a complication-free repair with an optimum postoperative speech.