Cross-Linked Hyaluronic Acid for Cleft Lip and Palate Aesthetic Correction: A Preliminary Report

Use of Hyaluronic Acid Filler in Patients with Secondary Cleft Lip Deformity

METHODS

Retrospective case note review was undertaken of all patients treated in the clinic over a two-year period.

RESULTS

20 patients underwent HA filler injections to the upper lip 26 times. Most were female (F:M = 3:1) and patients were aged 18-58 years. Most patients had a unilateral cleft lip +/- palate (n = 13, 65%). The most common indication was to address upper lip volume (n = 13, 65%). Other indications included vermillion notch (n = 5, 25%), cupid bow peak height asymmetry (n = 4, 20%), scar asymmetry (n = 1, 5%) and nasal sill flattening (n = 1, 5%). Small volumes of filler were used with an average of 0.34 ml (range 0.05-1.2 ml). There were no complications and one patient reported pruritis post procedure.

CONCLUSIONS

HA filler is a safe and reliable treatment for certain aspects of asymmetry following cleft lip repair. It can be used to address volume deficiency and asymmetry, cupid bow peak height discrepancies and a vermillion notch for patients who do not want surgery. Injection of HA to the lips can be performed easily, with appropriate training, in the outpatient setting.

Three-Dimensional Morphological Study on the Effectiveness of Expanded Polytetrafluoroethylene Prosthesis in the Paranasal Augmentation

BACKGROUND

The paranasal depression is a common facial feature of Oriental populations. One of the most wildly used method to improve it was paranasal augmentation using expanded polytetrafluoroethylene (ePTFE). The effectiveness of it should be tested by three-dimensional morphological measurements.

METHODS

Patients who underwent paranasal augmentation using ePTFE between January 2017 and December 2022 were recruited in the study. The preoperative and postoperative clinical variables and three-dimensional measurement of patients were also collected. The satisfaction outcome were assessed.

RESULTS

By establishing a coordinate system based on the Frankfurt plane, 16 landmarks including nasal alar crest, subnasal point, upper lip, pogonion, glabella, sub-cheek, orbitale, tragion in left and right side of faces were marked. Five segments, 4 ratios, and 3 angles were measured based on it. The significant increase of segments, ratios, and angles indicated that paranasal augmentation could increase the protrusion of paranasal area, both in absolute value and relative proportion. The significant decrease of other data indicated that the protrusion difference between paranasal base and upper lip, forehead, and chin, respectively, were shortened after surgery. The average size of implant was 6.54 ± 1.02 mm, and the average increase of paranasal height was 4.38 ± 1.04 mm postoperatively. This indicates that two-thirds of its height will ultimately be reflected effectively in the sagittal elevation of the paranasal base.

CONCLUSIONS

Paranasal augmentation using ePTFE could effectively increase paranasal height and improve subunits relationships, and the ePTFE prosthesis should be designed and carve considering the 1/3 loss of height after implantation.

LEVEL OF EVIDENCE III

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