Unilateral cleft lip repair in the presence of a vermilion hemangioma

This case describes a repair of a unilateral cleft lip complicated by a lip hemangioma. The relevant issues regarding timing of the repair include safety of the procedure by minimizing blood loss during excision of the hemangioma and minimizing anesthesia risk. In obtaining a lasting cosmetic result, excision of the hemangioma would need to be done when the potential for residual tumor growth would be least likely (during tumor involution). Finally, the difficult issue of psychosocial concerns would balance the need for traditional early cleft repair with a definitive repair prior to increased social interaction in school. All these concerns were met with a delayed single-stage repair after partial involution of the hemangioma. We feel that a single-stage excision and lip repair is an acceptable option. It is reasonable to delay the cleft lip repair until significant involution of the hemangioma has occurred. An acceptable aesthetic result is obtainable.