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This one is about: Banking Tissue with Lip Repair

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Banking Tissue with Lip Repair

A parent writes:

The actual repair looks good, but for this big chunk of tissue below his lip. The surgeon said she had obviously left too much tissue behind the first time, but that it could be fixed up. She was talking about doing it when he was four or five, which seems like a long time to wait.

And another parent responds:

Our daughter also has this extra chunk of tissue on the bottom part of her upper lip at the repair site. It covers her teeth. In fact several people have commented about her "not having any upper teeth at her age" even though the teeth are there, you just can't see them. Our surgeon purposefully left all that tissue there because as the child's lip grows, the extra tissue will be there, so as not to leave her with a "thin" upper lip. Basically our PS said it is better to leave all tissue there now, and take it away later, than take it away too early and not be able to put it back.

Joanne Green responds:

This is called "banking the tissue". Extra tissue is left so that there is tissue available either for future surgeries (such as columnella lengthening) or for growth. It is simply far easier to use extra tissue than it is to come up with tissue you no longer have. Yes, it can be done, but the end result will not be nearly as good.

This is all about "staged repairs". A cleft repair is done is stages -- one stage setting up for the next stage. The plastic surgeon thinks like a chess champion -- several moves ahead. He leaves tissue now, so that he has it available in a couple of years down the road, when the tissue will be needed.

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