Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Via Manzoni 56, Rozzano.
Plastic Surgery Unit, MultiMedica Holding S.p.A., Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Sesto San Giovanni, Milan, Italy.
J Craniofac Surg. 2021;32(2):642-646. doi: 10.1097/SCS.0000000000007028.
Cleft lip and/or palate (CL/P) is the most common congenital craniofacial malformation. The severity of the anatomic deformity is highly variable and different techniques can be employed depending on whether the defect is unilateral or bilateral, complete or incomplete. Patients usually undergo multiple steps of reconstruction throughout childhood and adolescence and, for this reason, secondary deformities of the nasolabial region of the midface may ensue. Considering our experience in the treatment of scars, we opted to correct the cleft lip surgery sequelae not only with local flaps/scar revisions, but we decided to add the use of the autologous fat grafting (AFG) to induce a regenerative effect in these young patients.
In this study we present the results obtained from a series of 12 consecutive Caucasian patients aged from 23 to 44 years with widened paramedian lip scars secondary to cleft lip reconstruction surgery, treated with a combination of needle-induced lysis of the scar tissue and AFG from January 2013 to December 2018.
After the procedure we observed an overall improvement in the quality of the scar tissue, in the function of mimic features, in the symmetry and cosmetics of the lower third of the nose. Patients' satisfaction was excellent. Results were long lasting and remained virtually unchanged after 1 year of follow-up.
Scar release by needle, AFG and local flaps are excellent tools for the treatment of cleft lip correction sequelae, but the combination of these surgical techniques can lead to even better results.Level of Evidence: Level V.
唇腭裂（CL/P）是最常见的先天性颅面畸形。解剖畸形的严重程度差异很大，根据缺陷是单侧还是双侧、完全还是不完全，可以采用不同的技术。患者通常在儿童期和青春期经历多次重建步骤，因此可能会出现中面部鼻唇区域的继发畸形。鉴于我们在治疗疤痕方面的经验，我们选择不仅通过局部皮瓣/疤痕修整来纠正唇裂手术后遗症，还决定使用自体脂肪移植（AFG）来诱导这些年轻患者的再生效应。
本研究介绍了我们从 2013 年 1 月至 2018 年 12 月期间，连续治疗的 12 例连续的白种人患者（年龄 23-44 岁）的治疗结果。这些患者由于唇裂重建手术导致的中线旁唇疤痕变宽，接受了针诱导的疤痕组织松解和 AFG 的联合治疗。
手术后，我们观察到疤痕组织的整体质量、表情功能、鼻下部的对称性和美观性都得到了改善。患者满意度非常高。结果持久，随访 1 年后几乎没有变化。
针、AFG 和局部皮瓣释放疤痕是治疗唇裂矫正后遗症的极好工具，但这些手术技术的结合可以带来更好的效果。
V 级。
