Other Scar Types: Optimal Functional and Aesthetic Outcome of Scarring in Cleft Patients

Abstract

Cleft lip and palate are facial and oral malformation due to failures in the embryologic craniofacial development during early pregnancy. A unilateral cleft lip and palate is the most common type, whereby the upper lip, the orbicularis muscle, the alveolar bone, the floor of the nose, and the hard and soft palate are interrupted, creating an open communication between nasopharynx and oropharynx. Patients with a cleft lip and palate are treated in specialized cleft centers by a multidisciplinary team. Having cleft lip and/or palate has a noteworthy impact on quality of life and psychosocial functioning. Postoperative scarring is a common cause of patient dissatisfaction. The goal of cleft lip surgery is to close the lip, provide optimal function in terms of speech, mastication, dental protection, breathing and feeding, and provide an aesthetically pleasing facial scar. Precise surgical technique and adequate aligning of anatomical structures is important for the postoperative aesthetic result and scar formation. Different surgical techniques are available for this purpose. Optimal scar management can be divided in surgical (precise surgical technique, planning, and adequate aligning of anatomical structures) and nonsurgical methods (botulinum toxin, silicone application, carbon dioxide fractional laser).

A new digital measurement system for assessing the lip in patients with cleft lip and palate (CLP)

“…In particular, wide conspicuous scar ratios, hypertrophic scars, or scars at the suture insertion sites, due to knots that are too tight or suture material left in-situ too long, are very noticeable and are most likely to cause dissatisfaction in affected individuals. 10 In addition to superficial deformities, muscular deficits, some due to inaccurate reconstruction, result in further problems. 11 …”