Modification of Noordhoff Flap for Tubercle Reconstruction in Unilateral Cleft Lip Repair

Background: Tubercle aesthetics are under-emphasized in unilateral cleft lip repair. Teenagers and adults with repaired cleft lip often display a central whistle deformity medial to the cleft lip scar. Lateral segment vermillion elements that are often discarded at the time of the initial repair can be used for tubercle reconstruction. Methods: We obtained anthropometric measurements of the dry vermilion around the central tubercle in neonates with unilateral cleft lip to determine the extent and morphology of deficiencies. A modification of the Noordhoff vermillion flap is proposed with a trapezoidal configuration to precisely match the measured, dry vermillion deficiency. Results: Photographic documentation illustrates the surgical technique and results. Conclusions: Tubercle reconstruction is described using a modification of the Noordhoff flap. Four-year results are encouraging. Observations through maturity are needed.