{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:14:14Z","timestamp":1784268854182,"version":"3.55.0"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1S","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Secondary cleft lip deformities (SCLD) are common, diverse, and individually unique due to their multifactorial etiology and varied clinical presentation. They are the result of postoperative complications of primary cleft lip repair, such as lip dehiscence, delayed wound healing, hematoma, infection, trauma, suture abscesses, poor operative planning, and inadequate surgical technique. The broad spectrum of these deformities and the absence of a standardized stratification framework necessitated the development of a comprehensive and universally applicable classification system. This system was designed to provide a simplified, consistent approach to identifying and categorizing residual cleft deformities. By doing so, it enhances communication among cleft care providers and facilitates the planning and execution of appropriate corrective procedures. The proposed classification organizes SCLD into 5 types (type I to V) based on the anatomic structures involved: skin, mucosa, orbicularis oris muscle, nose, and premaxilla. Each type corresponds to a specific pattern of tissue involvement and is associated with a tailored surgical approach described in this chapter. A careful preoperative assessment using this classification system significantly improves surgical planning, guides anesthetic considerations, ensures more accurate time and resource allocation, and promotes effective interdisciplinary communication.<\/jats:p>","DOI":"10.1097\/sap.0000000000004697","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:01:30Z","timestamp":1773237690000},"page":"S104-S113","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Cleft Lip Revision"],"prefix":"10.1097","volume":"97","author":[{"given":"Usama S.","family":"Hamdan","sequence":"first","affiliation":[{"name":"Global Smile Foundation, Norwood, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Andari","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Zeineddine","sequence":"additional","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Pontell","sequence":"additional","affiliation":[{"name":"Division of Pediatric Plastic Surgery, Monroe Carell Jr. Children\u2019s Hospital at Vanderbilt, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Bleynat","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons, Ireland University of Medicine and Health Sciences, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn E.","family":"Wan","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons, Ireland University of Medicine and Health Sciences, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson","family":"Alfonso","sequence":"additional","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland K.","family":"Assaf","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"R1-20260717","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1597\/14-158","article-title":"Early surgical complications after primary cleft lip repair: a report of 3108 consecutive cases","volume":"52","author":"Sch\u00f6nmeyr","year":"2015","journal-title":"Cleft Palate Craniofac J"},{"key":"R4-20260717","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1597\/11-256","article-title":"Adult cleft lip repair under local anesthesia: an effective technique in resource-poor settings","volume":"50","author":"Eberlin","year":"2013","journal-title":"Cleft Palate Craniofac J"},{"key":"R5-20260717","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1597\/14-099","article-title":"Primary premaxillary setback and repair of bilateral complete cleft lip: indications, technique, and outcomes","volume":"53","author":"Vyas","year":"2016","journal-title":"Cleft Palate Craniofac J"},{"key":"R6-20260717","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1177\/1055665618782806","article-title":"Premaxillary setback with posterior vomerine ostectomy: outcomes of single-stage repair of complete bilateral cleft lip with a severely protruding premaxilla","volume":"56","author":"Almas","year":"2019","journal-title":"Cleft Palate Craniofac J"},{"key":"R7-20260717","doi-asserted-by":"crossref","first-page":"e1402","DOI":"10.1097\/GOX.0000000000001402","article-title":"Synchronous premaxillary osteotomy with primary cheiloplasty for BCLP patients with protrusion of the premaxillae","volume":"5","author":"Kobayashi","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"}],"container-title":["Annals of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/SAP.0000000000004697","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:00:16Z","timestamp":1784268016000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/SAP.0000000000004697"}},"subtitle":["A Proven Classification for Surgical Precision and Resource Optimization"],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":5,"journal-issue":{"issue":"1S","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/sap.0000000000004697","relation":{},"ISSN":["0148-7043","1536-3708"],"issn-type":[{"value":"0148-7043","type":"print"},{"value":"1536-3708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"assertion":[{"value":"2026-01-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}