Analysis of secondary deformities of the lip and nose in children after primary unilateral cheiloplasty
DOI:
https://doi.org/10.63341/ijmmr/2.2025.107Keywords:
cleft, cartilage aplasia, palate, oral vestibule, reconstructive interventions, primary operation, asymmetryAbstract
The aim of the study was a comprehensive investigation of the morphological and functional features of secondary deformities of the lip and nose in children after primary unilateral cheiloplasty and the identification of the key structural manifestations. The study was carried out in the Department of Plastic and Reconstructive Microsurgery of the National Children’s Specialised Hospital “Okhmatdyt” in Kyiv from 2023 to 2025, within which 57 children with unilateral clefts were examined, with assessment of the parameters of three anatomical zones (upper lip, nose and oral vestibule) in the long-term period after primary cheiloplasty performed in other medical institutions. As a result of the study, it was established that secondary postoperative changes in the nasolabial region were observed in all children (100%), among whom aesthetic deformities were detected in 57.9% and anatomical defects in 42.1%. Moderate forms of
severity predominated (47.4%), whereas mild forms accounted for 31.6% and severe forms for 21.0%. The most frequent morphological changes of the upper lip were asymmetry of Cupid’s bow (80.7%), cicatricial changes (73.7%) and reduction of philtral height (66.7%), which were combined with impaired mobility in 50.9% of children. In the structure of the nose, asymmetry of the alae (77.2%), deformities of the columella (68.4%) and hypoplasia of the alar cartilage (63.1%) predominated. In the oral vestibule, common findings were reduction of depth (61.4%), scarring of the mucosa (70.2%) and oronasal communications (29.8%). A correlation was found between the severity of cicatricial changes and the reduction in vestibular depth (r=0.62; p=0.008), indicating the systemic nature of the secondary disturbances. The results obtained confirmed that secondary deformities of the nasolabial region after primary cheiloplasty are systemic in nature, with a predominance of aesthetic disturbances of moderate severity. The data can be used by surgeons, orthodontists, and speech therapists for planning reconstructive and rehabilitation interventions in children
Received: 06.08.2025 | Revised: 25.11.2025 | Accepted: 30.12.2025
References
Dmytrenko MІ, Smaglyuk LV, Hurzhii OV, Zenchenko DD, Romanchenko BV. Innovative approaches in complex
treatment of patients with congenital unilateral complete clefts of upper lip and palate. Kharkiv Dent J. 2024;1(1):94–
DOI: 10.26565/3083-5607-2024-1-10
Filonenko V, Kaniura O, Bidenko N, Iefymenko V, Iakovenko A. Multidisciplinary approach to the treatment of
children with congenital cleft lip and palate in Ukraine. Med Tod Tomor. 2024;93(1):75–85. DOI: 10.35339/
msz.2024.93.1.fkb
Alimdjanovich RJ, Ugli TNK. Clinical and anatomical features of nasal deformity in patients with unilateral
cleft lip and palate after cheiloplasty. Am J Med Sci Pharm Res. 2023;5(8):13–22. DOI: 10.37547/Tajmspr/
volume05issue08-04
Uchino N, Hoshi K, Takato T, Okayasu M, Saijo H, Nakatsuka T, et al. Follow‐up study of nasal deformity in cleft
lip and palate patients: Morphological changes and image analysis with growth. Oral Sci Int. 2020;18(1):62–72.
DOI: 10.1002/OSI2.1081
Oliinyk MY, Oliinyk AY, Oliinyk HV. Peculiarities of the orthopedic treatment of patients with congenital cleft upper
lip and palate after surgical interventions. Ukr Dent Almanac. 2024;2:70–6. DOI: 10.31718/2409-0255.2.2024.13
Shokirov ST, Mukimov II, Sharopov SG. Characteristics of anthropometric indicators of the face in patients with
congenital cliffs of the upper lip and palate after the main stages of the operation. Cent Asian J Med Nat Sci.
;4(1):38–42. DOI: 10.51699/cajmns.v4i1.1286
Neves MC. Assessment of lip profile and metric correlations through stereophotogrammetry in patients with
unilateral cleft lip and palate [Master’s dissertation]. Bauru: University of São Paulo; 2024. DOI: 10.11606/d.61.2024.
tde-04102024-144131
Schmutz S, Gkantidis N, Brudnicki A, Fudalej PS. Nasolabial shape and aesthetics in patients with cleft lip and palate:
Analysis of 3D facial images. Eur J Orthod. 2025;47(4):cjaf051. DOI: 10.1093/ejo/CJAF051
Kovach Y, Long MA, Kovach SJ, Bauder AR, Shelelo Y, Kizman D, et al. Free-tissue transfer for pediatric palatal fistula in
Ukraine: A model for surgical innovation in conflict setting. Face. 2025;6(4): 791–6. DOI: 10.1177/27325016251361318
Chen Y, Wang X, Wu J, Zeng W, Yang K, Sun Y, et al. A new algorithm for secondary repair of unilateral cleft lip nasal
deformity. Laryngoscope. 2024;134(4):1648–55. DOI: 10.1002/lary.31167
State Non-Commercial Enterprise “National Children’s Specialized Hospital “Okhmatdyt” Ministry of Health of
Ukraine”. Indications for referral to a consultative and diagnostic clinic [Internet]. [cited 2025 January 14]. Available
from: https://ohmatdyt.com.ua/likuvatis/poliklinika/yak-do-nas-potrapiti/
WMA Declaration of Helsinki – Ethical principles for medical research involving human participants [Internet].
October 19 [cited 2025 January 14]. Available from: https://surl.lu/dawjwn
Yao CA, Mulliken JB. The unilateral cleft lip nasal deformity: Revisions within 20 years after primary correction. Plast
Reconstr Surg. 2021;147(6):1379–87. DOI: 10.1097/PRS.0000000000007998
Hamdan US, Kantar RS, Al Abyad OS. Secondary cleft lip deformity. In: Hamdan US, Rogers-Vizena CR, Vyas RM,
Sommerland BC, Low DW, editors. Interdisciplinary cleft care: Global perspectives. San Diego: Plural Publishing;
Corthouts P, Boels F, van de Casteele E, Nadjmi N. Effects of various surgical protocols on maxillofacial growth in
patients with unilateral cleft lip and palate: A systematic review. Plast Aesthet Res. 2020;7:46. DOI: 10.20517/2347-
2020.97
Roohani I, Trotter C, Shakoori P, Moshal TA, Lasky S, Manasyan A, et al. Lessons learned from a single institution’s
eight years of experience with early cleft lip repair. Medicina. 2023;59(10):1741. DOI: 10.3390/medicina59101741
Bohneberger G, Ernica NM. Impact of cheiloplasty and palatoplasty on the quality of life of children with cleft lip and
palate. Cleft Palate Craniofac J. 2025;10556656251328089. DOI: 10.1177/10556656251328089
Branson EK, Branson VM, McGrath R, Rausa VC, Kilpatrick N, Crowe LM. Psychological and peer difficulties of
children with cleft lip and/or palate: A systematic review and meta-analysis. Cleft Palate Craniofac J. 2022;61(2):258–
DOI: 10.1177/10556656221125377
Khan ZA, Vura N, Gaddipati R, Ramisetti S, Beeram R, Kishor K. Assessment of nasolabial parameters following
cheiloplasty using modified delaire’s technique. Malaysian J Oral Maxillofac Surg. 2023;21(1):15–21. DOI: 10.4103/
mjoms_2023211_15
Schwaiger M, Edmondson SJ, Wallner J, Mischak I, Echlin K, Paddle A, et al. Influence of different techniques
of secondary cleft lip revision surgery on upper lip projection. Int J Oral Maxillofac Surg. 2020;49(6):726–33.
DOI: 10.1016/j.ijom.2019.10.010
Abdullateef KS, Nagaty MA, Fathy M, Elmenawi KA, Aboalazayem A, Abouelfadl MH. The outcomes of modified
millard technique versus tennison-randall technique in unilateral cleft lip repair: A comparative trial. Afr J Paediatr
Surg. 2024;21(1):12–7. DOI: 10.4103/ajps.ajps_99_22
Zaidov M. Surgical techniques used in cleft lip reconstruction. Gate Univ. 2025;1(3):245–53. DOI: 10.69760/
portuni.010320
Shaikh AI, Khan AH, Tated S, Khubchandani N. Functional and aesthetic outcome of different methods of
reconstruction of full thickness lip defects. GMS Interdiscip Plast Reconstr Surg DGPW. 2022;11:Doc02. DOI: 10.3205/
IPRS000163
Yue H, Piao Z, Cao H, Chen H, Huang L. Secondary correction of nasal deformities in cleft lip patients using
acellular dermal matrix grafting on the nasal tip with open rhinoplasty. Brit J Oral and Max Surg. 2023;61(6):416–21.
DOI: 10.1016/j.bjoms.2023.04.003
Cho BC, Park TH, Ryu JY, Lee JS, Choi KY, Yang JD, et al. Correction of severe secondary cleft lip nasal deformity.
J Craniofac Surg. 2022;33(2):404–8. DOI: 10.1097/scs.0000000000008311
Nguyen HL, Hoang MP, Nguyen VM, Tran TT, Le VS. Use of septal cartilage in rhinoplasty to correct nasal deformity
after unilateral cleft lip and palate surgery. Clin Cosmet Investig Dent. 2022;2022(14):131–40. DOI: 10.2147/ccide.
s364332
Zhang Z, Huang TC, He Y, Li S, Li Z, Chen J, et al. Modified use of costal cartilage in Asians for the correction of
nostril asymmetry in unilateral secondary cleft lip nasal deformity. Ann Plast Surg. 2021;86(2):175–81. DOI: 10.1097/
sap.0000000000002503
Yuan J, An Y. Improvement in nasal airway obstruction after secondary rhinoplasty for cleft lip: A systematic review.
J Plast Reconstr Aesthet Surg. 2024;90:130–48. DOI: 10.1016/j.bjps.2024.01.023
Yusof MS, Ibrahim HM. The impact of cleft lip and palate on the quality of life of young children: A scoping review.
Med J Malaysia. 2023;78(2):250–8.
Nguyen NH, Hall AE, Taylor JM, Lee JC. Psychosocial functioning in patients with cleft lip and palate: A narrative
review of the literature. Face. 2025;6(2):312–21. DOI: 10.1177/27325016251327665
Sarrami SM, Skochdopole AJ, Ferry AM, Buchanan EP, Hollier LH, Dempsey RF. Revisional techniques for secondary
cleft lip deformities. Semin Plast Surg. 2021;35(2):65–71. DOI: 10.1055/s-0041-1728673
Gille VL, Cornelissen AJM, Foulon I, Booi DI, van der Hulst RRWJ, Hamdi M, et al. Application of postoperative
nasal retainers in primary cleft cheilorhinoplasty: A review providing practical tips and tricks. J Craniofac Surg.
;36(4):1156–61. DOI: 10.1097/scs.0000000000011156
Arpacı MF, Özbağ D, Aydın Ş, Şenol D, Baykara RA, Çiçek İB. Evaluation of the relationship between nasal septal
deviation and development of facial asymmetry with anthropometric measurements depending on age. Int J Pediatr
Otorhinolaryngol. 2022;159:111207. DOI: 10.1016/J.IJPORL.2022.111207
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Oleh Holubchenko

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.









