Surgical treatment of the acute columellar-labial angle.

[BACKGROUND] The acute columellar-labial angle is associated with a long upper lip and can promote disharmony in the adult face. The different alloplastic or biologic materials used to correct this defect all have some disadvantages.

[OBJECTIVE] The authors propose the concomitant treatment of the acute columellar-labial angle, associated or not with the retracted columella and/or shortening of the lower lip, by rotating cutaneous flaps of the upper lip into a columellar pocket.

[METHODS] The superior border of an upper lip flap was defined by a line drawn from the columellar-labial fold and extending laterally, contouring the nostrils. The inferior border was defined by a second line parallel to the first but in a lower position, meeting the upper border at the lateral margins. The flap was deepithelialized and elevated from the lateral margins to the central area (pedicle). After the flap edges were sutured together, it was rotated into a columellar pocket. The donor site was sutured.

[RESULTS] Twelve patients underwent treatment as a single procedure, while 13 received surgery for the columellar-labial angle in association with a face lift. In all patients, the acute columellar-labial angle increased, and the retracted columella associated with shortening of the upper lip was filled in.

[CONCLUSIONS] Rotation of the upper lip flap into the columellar pocket results in a significant enlargement of the columellar-labial angle and shortening of the upper lip.