田中哲一郎 on Instagram: "External nose and scar revision after cleft lip. Six months post-surgery It's been 50 years since the patient's first cleft lip surgery at another hospital. I'm incredibly honored that the patient chose me. Above all, it's all a…173 likes, 24 comments - tetuichiro on November 13, 2025: "External nose and scar revision after cleft lip. Six months post-surgery It's been 50 years since the patient's first cl…

www.instagram.com

External nose and scar revision after cleft lip.
Six months post-surgery

It's been 50 years since the patient's first cleft lip surgery at another hospital.
I'm incredibly honored that the patient chose me.
Above all, it's all about form.
The most difficult part was moving the alar slightly toward the center. Since there was excess tissue, the only option was to remove it in the direction of the nasolabial folds (Burow's triangle).
All of the tissue was removed using 45-degree oblique incisions, and the dermis was reconnected.
A Z-shaped flap was used to replace the nasal floor.

Six months have passed.
As expected, the oblique incisions look beautiful.
Dermal suturing is difficult, but it's worth it.

It's not in textbooks, but I think the era of oblique incisions is coming.

口唇裂後の外鼻・瘢痕修正。
術後６か月

他院の口唇裂初回手術より50年経ってます。
私を選んで頂き、身が引き締まりまくりです。
とにかく、形態勝負。
難しかったのは、鼻翼をやや中央に寄せました。

組織が余るので法令線方向で組織を除去するしかありません（Burow's triangle)
全て45度の斜切開で除去、真皮を繋いでます。
鼻腔底はZで皮弁入れ替えました。

6ヶ月経ちました。
やはり、斜切開がキレイです。
真皮縫合が難しいですが、その価値はあります。

教科書には載ってないですが、斜切開の時代が来ると良いです

口唇裂初回手術より５０年後の修正