The diamond vermilion flap - A new technique for vermilion augmentation incleft lip repair

Objective: In most cleft lips patients, the vermilion on the medial aspect of the repair is deficient in height. Not many surgeons have dealt with way s to augment the height of the vermilion at this location. In the unilatera l cleft lip, the repair may include the insertion of a small triangular ver milion flap from the cleft side into an incision made for it in the muco-ve rmilion junction of the noncleft side. We have developed a new technique to further augment the vermilion in incomplete cleft lip patients. Method: Vermilion remnants may be present in these patients on the scar tis sue between the margins of the cleft. A diamond-shaped vermilion flap based on its attachments to the orbicularis oris muscle may be transposed into t he noncleft side to an incision made caudal and parallel to the muco-vermil ion border. Then the triangular vermilion flap may be inserted just distal to the island flap. Using this method, the vermilion is augmented and the m uco-vermilion line parallels more the white skin roll.