Interesting case of cleft lip mustache repair - Dr. Gabel

**Steven Gabel, MD** · 04-29-2010 09:58 AM

This patient is a 46 year old gentleman who desired to have his mustache repaired. He was born with a cleft lip and palate, which caused a significant gap in the tissues of the upper lip, and if the cleft extends into his mouth, the roof of the mouth can have a large gap that then has an opening into the bottom of the nasal cavity called a cleft palate.

He has undergone numerous surgical procedures to repair the cleft lip and cleft palate. He has had bone grafts placed into his mouth to reconstruct the roof of his mouth so he can swallow and breathe properly (see photograph of roof of mouth). He has had several surgical procedures on his lip and nose. He recently had his jaw split and moved forward for proper alignment.

To say it has been a long struggle is an understatement. He is a really nice person with a great attitude overcoming a tough problem. Thankfully, at this point, he is doing very well. The one area now that bothers him is the gap in his mustache. He uses his mustache to cover some of the scars in his upper lip; however, no hair is growing in that area and he feels people notice it more because of the lack of hair.

We had several conversations about the procedure and the possibility that the hair would not grow in the scar tissue because of how thick the scar is and possibility of poor blood supply. He understood the risk and decided to go ahead with the procedure.

He underwent a transplant to his upper lip and it went great. While making the slits, I felt that there was a good blood supply from the bleeding that occurred. We transplanted 255 grafts into the upper lip in a focused area where he lacked hair. The grafts were oriented very carefully to follow the natural direction of his mustache. Overall he tolerated the procedure well and I'll keep this post updated on its growth and progress. The patient will be following this post and I wanted to thank him for allowing me to share his experience.

**heresjohnny** · 04-29-2010 06:11 PM

Dr Gabel, indeed it seems he’s been down a hard road with this. It looks great I'm sure he is ecstatic! Where did you get pull the donor graphs from ?