First, fixed-point design
1) Find the point on the red edge of the lip first.
Find the peak point D and the lowest point C in the red edge of healthy lips, and then press CB=CD to determine the point B, and the point B' is set at the thickest part of the red edge of affected lips. Finally, B and B are stitched together to form the labial peak of the affected side.
2) measure two basic data
From the base of alar to the base of columella, the width of normal nostril and the base of affected nostril were measured respectively, and the difference between them was X. H measured from the midpoint of contralateral nasal floor to point D was the normal lip height, that is, the upper lip height that should be restored after the repair operation.
3) Set other points and underline them.
The fixing points a and A' are fixed on both sides of the nasal floor fissure. Let AA' be equal to the difference X of the width of the bottom of two nostrils, and make AA' equal after sewing. Connect AB. Subtract AB from normal lip height H to get Y, which is the lip height to be increased on the affected side. At point b, BE is about =y, almost parallel to the red edge of the lower lip. Take A' as the center, AB as the radius, B' as the center, Y (the lip height to be increased) as the radius, make an arc and intersect with B "(preferably B'B" is almost perpendicular to the red edge of the lip). Make an arc with b' b' as the center and BE as the radius, intersecting with e'. Connect the lines A' b', B' e' and E'B' (be careful not to draw the line B' b "or make an incision here). After correcting each point, puncture the skin with a hypodermic needle dipped in methylene blue, draw a line and fix it with iodine.
Second, incision and suture
The operation requires meticulous, light, small trauma, accurate incision and neat suture. When cutting, first pinch the upper lip outside the incision with your fingers to reduce bleeding. Cut A'B ",b' e", A'B ",B'E' and E'B" in turn according to the design line. After incision, the upper lip of the healthy side can descend, forming a triangular crack at BE. Insert the B "e' b "triangular tissue flap formed on the affected side into this fissure. The wound edge of AB line is opposite to A' B' suture layer by layer in turn. Trim the red lip, according to the situation, adopt embedded or Z-shaped double triangular flap method to increase the fullness of the red lip. Generally speaking, patients with nasal deformity advocate postponing the radical operation of nasal deformity after 13 years old. The fissure of complete cleft lip is wide and the tension is high, so it needs to be cut in the vestibular sulcus for invisible separation, which is convenient for tissue suture in place.