AUGMENTATION OF THE FREE BORDER OF THE LIP IN CLEFT-LIP PATIENTS USING TEMPOROPARIETAL FASCIA

Deficiency of the free border of the lip is frequently encountered in secondary cleft lip deformities. The free border of the lip consists o f the orbicularis oris marginalis muscle and its overlying subcutaneou s tissue, vermilion, and mucosa. The pathology may involve any or all of these components. When there is an absolute shortage of subcutaneou s tissue or orbicularis oris marginalis muscle, extra tissue from anot her source must be used for augmentation. A temporoparietal fascial gr aft is a simple and reliable method to increase the fullness of the fr ee border of the lip. The tissue is soft in consistency and displays m inimal resorption. Most important, more complicated procedures such as an Abbe' flap or tongue flap may be avoided. From July of 1988 until June of 1992, the temporoparietal fascial graft was used successfully to correct deficiencies of the free border of the lip in 20 patients w ith cleft lip deformities. There were two graft exposures that healed with conservative treatment. The procedure is a useful method of augme nting both lateral lip and central lip deficiencies in secondary and t ertiary cleft lip deformities.