The modified Abbe flap procedure is indicated in secondary unilateral cleft lip in which the Cupid's bow and philtral complex of the cleft side have been destroyed as the result of previous faulty surgery. The Abbe flap is inserted in the center of the tight upper lip with or without prior scar revision, which may be done several months beforehand. The recipient pocket for the flap is made by dividing the upper lip into two parts at the line of the philtral ridge in the noncleft side and bringing the whole prolabial tissue with the residual lateral lip to the cleft side of the upper lip. The natural midline groove included in the lower lip flap is enhanced by a traction suture and simulates a philtral dimple with the split philtral ridges on both sides. Various other techniques are used to improve the final result.
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