Orbicularis oris muscle: a double-breasted suture for its repair in the unilateral cleft lip.

The release of abnormal insertions of orbicularis oris muscle from the columella and ala base, and from their inferior attachments along the labial margin, provides muscle flaps for a double-breasted suture in cleft lip repair. Using the muscle flaps for double-breasted sutures realigns the orbicularis oris muscle fibers to achieve an anatomical and functional repair that is characterized by a symmetrical lip length, nostrils, philtral column, and philtral dimple. Double-breasted sutures also increase muscle thickness surrounding the lip and consequently provides better symmetry for the nostril floor.