Some patients who had previously undergone repair of a cleft lip may request revision to the vermillion of the upper lip. Typically they may desire correction of a defect or notch in the line of the cleft. In patients with a unilateral cleft, there may be asymmetry of the vermillion. In patients with bilateral cleft lip, there may be a deficiency of vermillion in the central segment.

Several methods have been described to fill isolated defects or augment free border of the lip including muscle plication (Aiache, 1991); local flaps (Kapetansky, 1971; Rodgers and Mulliken, 1989)INTRODUCED_TEXT; grafts of autologous tissue e.g. fat (Alighieri et al., 2020), fascia (Chen et al., 1995; Lee and Koh 2012), dermis ± fat (Patel and Hall, 2004; Abdali et al., 2017; Resnick et al., 2018); implantation of absorbable synthetic materials like hyaluronic acid (Schweiger et al., 2008) and permanent materials (Paddle et al., 2018).

Since 2006, the senior author has been using running V plasty (Aiache, 1991; Samiian, 1993) but modifying the method by leaving the donor site open on the buccal surface. This heals by epithelialisation allowing the lip to heal with a remarkable consistency to the on table appearance. We find this method is a safe and permanent alternative to implants and injectable materials.