Research Article| Volume 65, ISSUE 10, P1331-1334, October 2012

Reconstruction of vermilion deficiencies: The running V-flap technique


      Notching, or ‘whistle deformity’, is a common vermilion deformity among patients with cleft lips. Vermilion volume deficiency may also be present secondary to trauma or tumour excision. Herein, we present a new flap model to repair such vermilion deformities.
      Six patients were included in the study. Running V-flaps prepared from the oral mucosa were used.
      While the underlying cause of vermilion deficiency was cleft-lip surgery in four of the patients, the indication for surgery was trauma related in two patients. In all patients, the volume deficiency was corrected. No patient exhibited scarring, colour mismatch or asymmetry.
      We believe that our new flap model can be a reliable alternative in secondary vermilion deficiencies.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Jian X.C.
        • Lei R.C.
        • Yin P.
        Classification and repairing investigation of the whistling deformities in the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair.
        Zhonghua Zheng Xing Wai Ke Za Zhi. 2005; 21: 261-263
        • Song T.
        • Yin N.
        • Li H.
        • Zhao Z.
        • Zhao M.
        • Huang J.
        Bilobed mucosal flap for correction of secondary lip deformities following cleft lip surgery.
        J Plast Reconstr Aesthet Surg. 2011; 64: 589-594
        • Grewal N.S.
        • Kawamoto H.K.
        • Kumar A.R.
        • Correa B.
        • Desrosiers III, A.E.
        • Bradley J.P.
        Correction of secondary cleft lip deformity: the whistle flap procedure.
        Plast Reconstr Surg. 2009; 124 (1590-8)
        • de Chalain T.
        • Black P.
        Secondary reconstruction of asymmetric volume deficits of the lips: a transverse twist flap technique.
        Br J Plast Surg. 2004; 57: 330-335
        • Mitsukawa N.
        • Hosaka Y.
        Secondary correction of deformities of the vermilion with exposed oral mucosa after cleft lip repair.
        J Craniofac Surg. 2008; 19: 1370-1373
        • Assunção A.G.
        • Ferreira L.M.
        • Mondelli R.L.
        Bilateral cleft lip and whistling deformity: the X flap procedure for its correction.
        Plast Reconstr Surg. 2006; 117: 1986-1991
        • Yin N.B.
        • Gao F.
        • Wang Y.Q.
        • Song T.
        • Li H.D.
        Correction of secondary bilateral complete cleft lip and whistling deformities: the advance and rearrangement of the bilateral lip tissues.
        Aesthetic Plast Surg. 2011; 35: 750-755
        • Jackson I.T.
        • Soutar D.S.
        The sandwich Abbe flap in secondary cleft lip deformity.
        Plast Reconstr Surg. 1980; 66: 38-44
        • Guerrero-Santos J.
        Use of a tongue flap in secondary correction or cleft lips.
        Plast Reconstr Surg. 1969; 44: 368-371
        • Ahuja R.B.
        Vermilion reconstruction with labia minora graft.
        Plast Reconstr Surg. 1993; 92: 1418-1419
        • Lee K.N.
        • Koh K.S.
        Acellular human dermis, a good option for correcting the free border deficiency in secondary cleft lip deformity.
        J Plast Reconstr Aesthet Surg. 2012; 65: 356-361
        • Wakami S.
        • Harada T.
        • Muraoka M.
        • Ishii M.
        Rectangular mucosal flap with artificial dermis grafting for vermilion deformity in cleft lips.
        J Plast Reconstr Aesthet Surg. 2010; 63: 22-27
        • Stal S.
        • Hollier L.
        Correction of secondary cleft lip deformities.
        Plast Reconstr Surg. 2002; 109: 1672-1681
        • Narsete T.A.
        V-Y advancement flap in upper-lip reconstruction.
        Plast Reconstr Surg. 2000; 105: 2464
        • Lassus C.
        Thickening of thin lips.
        Plast Reconst Surg. 1981; 68: 950-952
        • Aiache A.E.
        Augmentation cheiloplasty.
        Plast Reconstr Surg. 1991; 88: 222-226
        • Mutaf M.
        V-Y In V-Y procedure. New technique for augmentation and protrusion of the upper lip.
        Ann Plast Surg. 2006; 56: 605-608