Techniques for Determining the Placement of Surgical Incision Points to Adjust the Length of the Philtral Ridges

OBJECTIVE: To evaluate whether medial shifting of the incision reference point increases cleft-side philtral ridge length in unilateral cleft lip repair. DESIGN: Retrospective comparative study. PATIENTS: Thirty-six patients with unilateral cleft lip with or without cleft palate who underwent cheilorhinoplasty by a single surgeon. INTERVENTIONS: Patients were divided according to the incision reference point: group A, at the junction of the cleft-side nostril margin and columellar base; and group B, slightly medial to this point. MAIN OUTCOME MEASURES: Preoperative and immediate postoperative cleft-side philtral ridge length, lengthening amount, lengthening ratio, and cleft/non-cleft ratio. RESULTS: No statistically significant intergroup differences were observed in cleft type distribution or any measured outcome. Lengthening amount and ratio were numerically higher in group B, but not significantly different. CONCLUSIONS: Medial shifting of the incision reference point showed a nonsignificant tendency toward greater philtral ridge lengthening. Larger studies with long-term follow-up are needed.