Secondary lip correction in unilateral clefts.

Although all surgeons try to achieve the best possible result in the primary operation of a cleft, a certain percentage of cases might still need secondary corrections. The causes include not only lack of experience of the surgeon, but also the reaction of a child with its individual scar formation, disturbance in the healing of the wound, or the growth of the face, any of which might give an unfavorable result. In secondary operations we must distinguish between minor and major problems. Sometimes different parts of the cleft area will need correction and it is difficult to separate the problems totally from each other. Therefore a careful evaluation of the primary result is necessary. In secondary lip correction, the combination with nasal deformity must always be evaluated. When unfavorable results are present after the primary operation, several different methods allow the surgeon to make a cleft lip symmetrical and inconspicuous.