Assessment of the need for a cosmetic lip procedure after surgical repair in patients with cleft lip

Abstract

Background & Aim: Cleft lip patients suffer from some deformities after the surgical repair of the cleft, such as the visible scar, the short or thin lip, deformities in the vermilion, and other things that affect the aesthetic appearance of the lip in particular and the face in general.

This study aimed to determine the need for a cosmetic procedure after the surgical repair of a cleft lip at the Oral and Maxillofacial Hospital of Damascus University.

Materials and Methods: The research sample consisted of 20 patients with a cleft lip who completed primary and secondary surgical repair operations, aged 16-30 years. The ratio of males to females was 4:1. Satisfaction with the appearance of the upper lip and the general appearance of the face was evaluated on a visual analog scale (VAS), in the form of a ruler listed with numbers 1-10, where 0 indicates 'not quite satisfied' or "unattractive" and 10 cm indicates 'fully satisfied' or 'very high and attractive'.

Three raters - the patient, the surgeon, and a layperson - were selected to score satisfaction after a complete surgical repair of a cleft lip, and the need for any additional cosmetic procedure.

Results: The total sample size of 20 patients was 20% male and 80% female.

The mean scores of satisfaction with the appearance of the lip and the general appearance of the face of the parents were 6.3 and 6.7, respectively. For the surgeon, it was 5.1 for the lip and 5.8 for the overall appearance of the face, while that of the layperson was 4.2 for the lip and 4.7 for the general appearance of the face.

As for the need for a cosmetic procedure for the lip, the patient indicated the necessity of the procedure in 57.5%, the surgeon in 67.5%, and the layperson in 77.5% of cases.

Regarding the scar assessment results according to the Patient and Observer Scar Assessment Scale (POSAS), there was no significant difference between the three assessors (p>0.05).

Conclusion: Patients were more satisfied with cleft lip repair than either the surgeon or the layperson. Those who needed a cosmetic procedure, there were approximately two-thirds of the cases, with varying percentages among the raters.