A New Method for Creating a Definite Philtrum by the Flipping of an Orbicularis Oris Muscle Flap in a Patient with an Indistinct Philtrum

The philtrum plays a key role in the appearance of the upper lip and nostril sill. Therefore,construction of the philtrum is crucial for attaining a natural appearance of the upper lip. Weused a flipping myoplasty of the orbicularis oris muscle on a patient with a flat philtrum inorder to effectively reconstruct the philtral dimple and column. A 35-year-old female presentedto our department with the complaint of a flat upper lip. A superficial layer of the orbicularisoris muscle on the median aspect of the upper lip was vertically incised and elevated to athickness of 2 mm. Both sides of the elevated muscle flap were then folded to the lateral sidesso that the border could be sutured onto the outer portion of the orbicularis oris muscle. Thepatient was observed for one year postoperatively. Her philtrum deepened by 1.25 mm, with thecentral angle of her Cupid’s bow improving from a preoperative measurement of 146° to 128°postoperatively. In a patient with an indistinct philtrum, a flipping orbicularis oris myoplastywas performed to attain a definite philtral column and a philtral dimple. Natural upper lipmovement was maintained, and an aesthetically and functionally satisfactory reconstructionwas achieved.