Vanessa Olichwer

Background: Despite advances in cleft rhinoplasty, the nasal sill remains an underappreciated subunit, yet it plays a crucial role in nostril symmetry and aesthetic balance. Hypoplasia or absence of the nasal sill on the cleft side often persists after primary repair and may complicate secondary nasal base correction. Current methods for sill reconstruction are limited by donor site morbidity, variability in tissue match, or non-anatomic tissue substitution. Methods: This technical note describes a surgical protocol utilizing the Tela Cutis Nasi flap, a pedicled fibro-adipose flap harvested from the adjacent nasal base, to reconstruct the deficient sill in patients with previously repaired unilateral cleft lip. The flap concept, anatomical rationale, stepwise operative steps, and patient selection considerations are outlined. Results: This technical note details the surgical steps, anatomical rationale, and flap design. No formal morphometric or patient-reported outcome analysis is included in this report; these data are being collected within an ongoing prospective outcome study designed to evaluate efficacy and long-term stability. Conclusions: The Tela Cutis Nasi flap is intended as an anatomically based local option for nasal sill reconstruction that can be integrated into secondary cleft nasal base surgery. This article contributes a standardized operative description, indications, technical constraints, and anticipated pitfalls, without assessment of clinical outcomes or long-term stability.

Background: The upper lip plays a central role in facial harmony and youthful appearance. Aging‐related changes include elongation of the philtrum, thinning of the vermilion, and reduced maxillary incisor show. Surgical lip lift shortens the cutaneous upper lip and enhances vermilion exposure, yet patient selection and outcome assessment remain non‐standardized. Objectives: To critically evaluate current evidence on surgical lip lift techniques, including the classical subnasal bullhorn approach and its modifications, and to provide evidence‐based recommendations for anatomy‐driven technique selection. Methods: A PRISMA 2020–compliant systematic review was conducted, with protocol registration in PROSPERO. Studies included adult patients (≥ 18 years) undergoing lip lift for aesthetic or aesthetic‐functional indications. Prospective and retrospective clinical studies and case series (≥ 5 patients) published between 2017 and 2025 were identified through database searches. Data extraction focused on surgical technique, morphometric outcomes, patient satisfaction, and complications. Meta‐analysis was not feasible due to heterogeneity. Methodological quality was assessed using the MINORS instrument and JBI checklists. Results: Seven studies comprising 1754 patients were included. Subnasal bullhorn techniques and their modifications reduced philtral length from 14.0–14.5 mm to 10.8–12.0 mm, increased vermilion height from 5.0–6.0 mm to 7.0–9.0 mm, and improved maxillary incisor show from 1.5–2.0 mm to 3.5–5.0 mm. Patient satisfaction was high (mean GAIS score 4.4/5). Complications were predominantly mild and transient, with revision rates of 0.6%–6.7%. Overall study quality was moderate. Conclusions: Surgical lip lift is a safe and effective procedure for restoring upper‐lip proportions. Technique selection should be individualized, and further prospective studies with standardized outcome measures are needed. Trial Registration: CRD420251232005