{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:57:27Z","timestamp":1790776647601,"version":"4.1.0"},"reference-count":10,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Objective<\/jats:title>\n To evaluate outcomes of precision dermal fat grafting (PDFG) for vermilion deficiency following cleft lip repair.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective cohort study.\u202f<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary care pediatric hospital.\u202f<\/jats:p>\n <\/jats:sec>\n \n Patients<\/jats:title>\n Individuals with vermilion deficiency following repaired unilateral or bilateral cleft lip.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Dermal fat grafts were placed at the site of deficiency. Grafts were oriented with dermis-side contacting and secured to the orbicularis oris, then covered with a V-Y mucosal advancement flap.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Upper lip measurements were obtained from pre- and postoperative photographs. Two vertical heights were measured from the point of greatest deficiency: (1) actual height\u2014from the point of greatest deficiency to the upper vermilion border, and (2) expected height\u2014from the upper to the lower vermilion border. Two reviewers performed measurements; interrater reliability was assessed using the intraclass correlation coefficient (ICC). Associations between patient factors and revision surgery were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The vermilion height ratio improved from 0.72 to 0.94 postoperatively (\n P<\/jats:italic>\n \u2009<\u2009.001), demonstrating increased vermilion volume. ICC was 0.81 (95% CI: 0.72-0.87), indicating excellent interrater reliability. Patients requiring revision had a lower preoperative actual-to-expected vermilion height ratio compared to those not requiring revision (\n P<\/jats:italic>\n \u2009=\u2009.043), suggesting that more severe initial defects may increase the likelihood of revision. Five patients required revision: 4 for excess (treated with excision) and 1 for deficiency (requiring repeat PDFG).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n PDFG is a safe and reliable technique for correcting vermilion deficiency in unilateral and bilateral cleft lip, offering predictable volume restoration with minimal complications.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/10556656251392330","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T16:08:05Z","timestamp":1763654885000},"page":"2749-2754","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vermilion Deficiencies After Cleft Lip Repair: Outcomes of Precision Dermal Fat Grafting Technique"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5574-078X","authenticated-orcid":false,"given":"Savannah C.","family":"Braud","sequence":"first","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evyn","family":"Neumeister","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erona","family":"Shurdhiqi","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milind","family":"Sangani","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7995-7256","authenticated-orcid":false,"given":"David","family":"Low","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oksana A.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3750-9305","authenticated-orcid":false,"given":"Joseph A.","family":"Napoli","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"},{"name":"Perelman School of Medicine, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221145057"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjab026"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619864221"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v088.i02"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619880056"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1998_035_0310_ioslsa_2.3.co_2"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10006-017-0648-8"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2021-246303"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004237"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2012.04.052"}],"container-title":["The 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