Triangular flap for atypical cleft lip. A modification in design.

Standardized steps or criteria for designing a triangular flap do not always fit for all types of cleft lip repair. Some compromise among the criteria is required, especially for atypical cases, such as those with a long vertical height on the noncleft side and a short lateral lip element. In order to secure symmetry in the horizontal length of vermilion, or in the distance from the peak of the cupid's bow to the mouth corner, E' should be located as high as allowable. The ratio of the length of the vertical incision to that of the triangular base affects the final shape of the repaired lip in many ways. Since the bottom of the cupid's bow is generally gradual, slight horizontal asymmetry in the cupid's bow is usually acceptable, as compared with that of the other components.