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Median Tubercle Augmentation Using Allogenic Dermis Graft Material : Case Reports

Forming the adequate amount of median tubercle volume in cleft lip patients is an important factor but also difficult to achieve. Mulliken emphasized the formation of the median tubercle and myocutaneous ridge from the lateral lip elements and the surgeon should consider growth speed differences in naso-labial areas before surgery. As a fast growing structure the vermilion-mucosal component (median tubercle) should be built larger than in a normal infant when performing primary lip repair. But even done so, the height of the median tubercle begins to fall behind the normal length during adolescence in approximately 1/3 of the patients. So the need of secondary lip repair and augmentation is necessary in some patients. Vermilion notching is one of the most common secondary deformities after primary lip repair. For significant deformities, rotation advancement flap is often necessary. For lesser deformities, many options exist, including local flaps, Z-plasties, and fillers. In this article we report 4 cases of median tubercle augmentation using allogenic dermis material (MegadermTM) during lip correction in secondary lip deformity patients.