KẾT QUẢ PHẪU THUẬT GHÉP TRUNG BÌ MỠ TRONG KHUYẾT THỂ TÍCH PHẦN MỀM MÔI ĐỎ DO DI CHỨNG KHE HỞ MÔI: BÁO CÁO 2 CA LÂM SÀNG

Abstract

Introduction: Cleft lip, a frequent congenital facial anomaly, often leaves lasting secondary issues like vermilion defects even after initial surgical repair. These imperfections can affect a patient’s appearance and emotional well-being. When orthognathic surgery isn’t an option, alternative methods are essential to restore balanced lip appearance and function. Case presentation: Two male patients, aged 11 and 13, presented with upper lip asymmetry, reduced projection, and scarring following unilateral cleft lip repair at 3 months and alveolar bone grafting at 10 years. Clinical evaluation revealed insufficient upper lip volume and unfavorable positioning relative to Ricketts’ esthetic line. Management and Outcome: Given the high cost and limited availability of orthognathic surgery in Vietnam, both patients underwent upper lip augmentation using autologous dermis fat grafts (DFG) harvested from the posterior iliac crest with concurrent scar revision. Grafts were contoured to correct medial tubercle deficiency and improve projection. At 3-month follow-up, upper lip measurements demonstrated advancement toward ideal E-line positioning, with notable improvement in fullness, symmetry, and aesthetic balance. No major complications occurred. Conclusion: Autologous DFG is a reliable and cost-effective option for correcting vermilion deficiencies in cleft lip patients, providing predictable volume enhancement and aesthetic improvement when more invasive orthognathic interventions are not feasible.