Aketa J, Nodai T, Kuga Y, Yamada N, Hirakawa M
Cleft Palate J. 1980 Jul;17(3):245-8.
In the natural form of the oral commissure, the outer edges of the upper and lower lips form small triangular flaps. The white line of the lip at the commissure is web continuous with the upper and lower red lips. The lower part of this web is larger than the upper. To repair this so that there is a natural appearance, a Z-plasty and mucocutaneous flap based inferiorly is performed on the transverse facial cleft. The incision line for the Z-plasty is made though each vermilion border and is extended approximately 1.5-2 mm to create the web continuous with red lips. The mucocutaneous flap is formed when making the incision through the lower vermilion border. As the flap is elevated and sutured to the upper lip, the larger web-like skin on the lower lip is made. This skin is seen to insert boldly into the oral cavity.