Abstract
Cleft lip is a common congenital deformity that significantly affects facial aesthetics, oral function, speech development, and psychosocial well-being. Traditional surgical techniques, such as Millard’s rotation-advancement and Tennison-Randall’s triangular flap have limitations in achieving optimal aesthetic outcomes, particularly in recreating a natural philtral column and a symmetrical nasal base.
In 2005, David M. Fisher introduced the anatomical subunit approximation technique, a modification that integrates concepts from previous techniques while emphasizing alignment along aesthetic subunits of the lip. This method utilizes precise markings and measurements to design incisions that follow the natural philtral column, combined with a small superiorly based triangle (average 1.24 mm) above the cutaneous roll for optimal lengthening without distorting Cupid’s bow. A laterally based vermilion flap is also employed to correct central vermilion deficiency, ensuring a continuous and harmonious vermilion border.
Studies have demonstrated that Fisher’s technique provides better outcomes in terms of scar camouflage, philtrum reconstruction, and nasal symmetry compared to traditional methods. However, it requires thorough anatomical knowledge and meticulous surgical planning due to its technical complexity.
This review highlights the principles, surgical steps, advantages, limitations, and reported clinical outcomes of Fisher’s technique for repairing unilateral complete cleft lip, emphasizing its importance as an advanced surgical approach in modern cleft care.
| Published | 2026-04-30 | |
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| Issue | Vol. 16 No. 02 (2026) | |
| Section | Reviews | |
| DOI | 10.34071/jmp.2026.2.756 | |
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Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
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