case_images: PMC9831653_01
case_images: Preoperative picture of the patient with bilateral commissural cleft.
case_images: rjac616f1.jpg
case_images: PMC9831653_01_rjac616f1.jpg
case_images: f1
case_images: The left zygomatic region was more prominent than the right (Fig. 1).
case_images: Graphic design of the commissural mucocutaneous flaps.
case_images: rjac616f2.jpg
case_images: PMC9831653_01_rjac616f2.jpg
case_images: f2
case_images: Surgery was started from the right site; various points for the design of the commissural mucocutaneous flaps were marked (Fig. 2).
case_images: Mucocutaneous flap raised keeping its base in the buccal mucosa.
case_images: rjac616f3.jpg
case_images: PMC9831653_01_rjac616f3.jpg
case_images: f3
case_images: Mucocutaneous flap was raised, keeping its base in the buccal mucosa (Fig. 3).
case_images: Accessory maxilla removed from the left site with a presence of a distal lesion.
case_images: rjac616f4.jpg
case_images: PMC9831653_01_rjac616f4.jpg
case_images: f4
case_images: The cleft on the right site was closed, after that we proceeded to the left, beginning with the removal of the bony lesion in the cheek where a linear incision was made and the bone was dissected and detached posteriorly to the maxilla (Fig. 4).
case_images: Z-plasty of both commissural cleft.
case_images: rjac616f5.jpg
case_images: PMC9831653_01_rjac616f5.jpg
case_images: f5
case_images: The closure of the left commissural cleft was done following the same principles applied to the right site (Fig. 5).
case_images: Facial appearance of the patient's face 1 year after surgery.
case_images: rjac616f6.jpg
case_images: PMC9831653_01_rjac616f6.jpg
case_images: f6