Influence of Cupid's Bow Peak Placement on Nasolabial Formation in Unilateral Cleft Lip Repair

ObjectiveTo clarify how the preoperatively determined position of the Cupid's bow peak on the lateral lip element affects postoperative nasolabial formation in patients with unilateral cleft lip. We hypothesize that setting the proposed peak of the Cupid's bow close to the nostril floor causes the cleft-side nasal alar base to droop while positioning it near the oral commissure shortens the red lip, causing an elevated cleft-side oral commissure.DesignRetrospective study.SettingSingle institution.PatientsTwenty-seven patients with non-syndromic complete unilateral cleft lip and palate (UCLP) who received primary lip plasty at our department.InterventionsPrimary lip repair for patients with UCLP.Main outcome measuresWe tested our hypothesis using three-dimensional facial images taken before and 1 year after primary lip repair. Bilateral measurements included lip height (distance between the nasal alar base and the Cupid's bow peak), red lip length, and the vertical height of the nasal alar base and oral commissure.ResultsCorrelation analysis showed a significant relationship between preoperative cleft-side lip height and the postoperative position of the cleft-side nasal alar base (<i>P</i> = .0024, Pearson's correlation analysis). Preoperative short red lip remained short afterwards (<i>P</i> = .000036, Pearson's correlation analysis), causing a lip cant with an elevated cleft-side oral commissure (<i>P</i> = .012, Pearson's correlation analysis).ConclusionsPostoperative nasolabial formation is influenced by the preoperatively proposed position of the Cupid's bow peak. This study provides a comprehensive principle explaining the relationship between the location of the proposed Cupid's bow peak on the lateral lip elements and postoperative nasolabial formation in primary lip repair in patients with unilateral cleft lip.