PMC7178842_01
Median cleft lip and flatted nasal dome in a 7-days old girl with lobar-type-holoprosencephaly.
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Her premaxilla, columellar, and nasal septal cartilage were completely absent, and the nasal dome was flatted without any support (Figure 1).
Naso-alveolar molding plate and its silicone globes, which support the nasal dome in the upward and forward direction.
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Frontally, on a customized resin plate, a curved steal wire and two silicone globes were attached to support the nasal dome up and forward (Figure 2).
Cheiloplasty performed after 18 months of PNAM. (a and b) Columellar reconstruction was performed with local flaps. Arrow: small white lip portions with lateral vermillion. (c and d) A skin graft was applied on the philtrum.
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Finally, at her age of 18 months, after estimating the tolerance to surgery, a definitive cheiloplasty was performed, which involved closing the lateral vermillion elements together at the labial center with small white lip portions (Figure 3), which finally induced the natural growth of cupid bow-shaped lips.
At seven months postoperatively.
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Seven months later, a well-formed cupid-bow lip with cupid peaks was observed, which was maintained for eight years postoperatively (Figures 4 and 5).
Defined cupid-bow of the lips, cupid peaks, and the columellar strut supporting the nasal dome after the eight-year follow-up period.
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Seven months later, a well-formed cupid-bow lip with cupid peaks was observed, which was maintained for eight years postoperatively (Figures 4 and 5).