An Evaluation of Surgical Outcome in Bilateral Cleft Lip Using Modified Millard Approach

Abstract

To handle premaxilla of Bilateral cleft lip cases is the biggest challenge for a surgeon. All the post-operative complication arises only at this area. Like labial fistula, fibrosis, scaring, inadequate development pre-maxilla causing incompetent lip etc. So, our art, technique and concentration for bilateral cleft lip surgery based on premaxillary work. Here is the modification of modified millard’s techniques- To save 2-3 mm mucous layer of premaxilla, the tissue which is discard by other techniques like Manchester techniques. Handle that tiny tissue; carefully place it in correct position which will give a long-term excellent aesthetic surgical outcome. In Bilateral cleft lip cases always, the premaxilla is short. We design and dissect and lengthen 1-2 mm and shape the upper lip with normal length. Mobilize the mucous layer from both sides, close the opening of cleft alveolus and built up a very good sulcus layer. This will help the normal development of premaxilla and will prevent the post-operative complication of bilateral labial fistula which is very common complication of bilateral cleft surgery.