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CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451807275
DOI: 10.1055/s-0045-1807275
Artigo de Revisão

Z-Plasty in Unilateral Cheiloplasty: Evolution and Techniques

Article in several languages: português | English
Isabela Bicalho Zaki 
1   Faculdade de Medicina, Centro Universitário das Américas (FAM), São Paulo, SP, Brasil
,
Ana Clara Rosa Coelho-Guimarães 
1   Faculdade de Medicina, Centro Universitário das Américas (FAM), São Paulo, SP, Brasil
,
Marcelo Luiz Peixoto Sobral 
1   Faculdade de Medicina, Centro Universitário das Américas (FAM), São Paulo, SP, Brasil
,
Vinchenzo Alberto de-Genaro 
1   Faculdade de Medicina, Centro Universitário das Américas (FAM), São Paulo, SP, Brasil
› Author Affiliations Financial Support The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.

Ensaios Clínicos Nenhum. | Clinical Trials None.
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Abstract

Introduction

Cleft lip and palate is the most common congenital deformity among craniofacial malformations. The treatment of cleft lip patients has crucial stages, with several surgical techniques, among which the most used is the Millard I. Initially, Z-plasty involved creating Z-shaped incisions along the edges of the cleft lip, but, eventually, more precise suturing techniques and absorbable suture materials started to be used in order to reduce tissue tension and enhance healing. The development of these modifications to the Z-plasty technique has led to better aesthetic and functional outcomes in unilateral cleft lip repair. Z-plasty has been extensively employed in unilateral cleft lips to achieve satisfactory aesthetic and functional results. The present study examines the most significant advances in Z-plasty technology and their impact on enhanced lip aesthetics and functionality.

Objective

The current study aimed to investigate the Z-plasty evolution in cheiloplasty, analyzing the technical developments achieved over time, focusing on improving aesthetic outcomes and restoring functionality in repaired unilateral cleft lips.

Materials and Methods

The article is a narrative summary from selected specific studies investigating the development of Z-plasty in cheiloplasty using electronic databases such as PubMed, LILACS, Scielo, and articles from the Brazilian Journal of Plastic Surgery (RBCP), and research on technical developments and the pros and cons of Z-plasty.

Results

Z-plasty is an effective and adaptable surgical technique, easily tailored to the demands of contemporary plastic surgery. Its remarkable evolution over the years demonstrates significant advances in aesthetic and functional outcomes, and new technical approaches are increasingly frequent to enhance the natural appearance of repaired lips.

Conclusion

Z-plasty has shown significant aesthetic and functional advancements in correcting unilateral cleft lips. Its adaptations improved symmetry and reduced the need for secondary surgeries. The technique selection must be careful, and a multidisciplinary approach is essential for optimal outcomes.

Keywords

cheiloplasty - cheilozetaplasty - cleft lip surgery - unilateral cleft lip - Z-plasty

Authors' Contributions

IBZ, ACRCG, MLS, and VADG: data analysis, interpretation, or both, statistical analysis, final manuscript approval, funding acquisition, data collection, conceptualization, study conception and design, resource management, project management, investigation, methodology, performance of surgeries, experiments, or both, writing - original draft preparation, writing - review and editing, software, supervision, validation, and visualization.




Publication History

Received: 09 April 2024

Accepted: 06 February 2025

Article published online:
30 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Isabela Bicalho Zaki, Ana Clara Rosa Coelho-Guimarães, Marcelo Luiz Peixoto Sobral, Vinchenzo Alberto de-Genaro. Zetaplastia em queiloplastia unilateral: Evolução e técnicas. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451807275.
DOI: 10.1055/s-0045-1807275
 

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