UNASSIGNED: Macrostomia is a congenital deformity found in Tessier no. 7 facial clefts defined as an enlargement of the mouth at the oral commissure. Several techniques are described in literature to achieve optimal functional and aesthetic results, with varying results and surgeon preferences. In this case series we report surgical repair of macrostomia with a vermillion square flap method for the oral commissure combined with either Z-plasty or W-plasty closure for the skin.
METHODS: A retrospective case analysis of 12 patients with macrostomia operated over the past 7 years at our plastic surgery division was performed (by two different operators; 11 cases by A.S. and 1 case by R.S.). Clinical features of the patients were analyzed through photography documentation, and patient description such as age of operation, operation technique, and complications were obtained through patient records. Macrostomia was corrected with a vermillion square flap method for commissure, overlapping muscle closure, along with either Z-plasty or W-plasty closure for the skin. Quality of lip commissure position, symmetry, thickness of vermillion, and scar result were recorded.
UNASSIGNED: In all twelve patients repaired with the overlapping muscle closure and square flap, the lip commissures were formed with satisfactory shape, position, and thickness with no commissure contracture during the follow up period. The Z-plasty was a simpler method compared to the W-plasty, and resulted in comparable scars. One patient (adult with hemifacial macrostomia and W-plasty skin closure) underwent revision surgery for more accurate symmetry and position of the oral commissure.
CONCLUSIONS: There are many varieties of surgical repair for macrostomia, and each method should be adjusted and combined according to each patient. Overall, macrostomia repair with this technique combination produced satisfactory aesthetic and functional results in all twelve patients. Z-plasty for skin closure after muscle and vermillion closure was a simpler technique and resulted in comparable scars than W-pasty closure in this case series.

Congenital double lip is a rare developmental anomaly which usually involves the upper lip more than the lower lip. It may occur in isolation or as a part of Ascher\'s syndrome. Sometimes upper and lower double lips occur simultaneously. The occurrence of double lip may result in facial deformity especially when the patient attempts to talk, smile or even show the teeth. It may also interfere with speech or mastication. Although surgery may be undertaken to facilitate speech and mastication, the majority of cases are operated for cosmetic reasons. A case of congenital double upper lip, which was surgically treated after orthodontic treatment, for cosmetic reasons, is reported. The different surgical approaches to the management of double upper lip are reviewed with a note on timing of surgery in patients who have concurrent orthodontic or prosthodontic problems. Although the majority of cases of double lip are treated by Plastic Surgeons and Oral and Maxillofacial Surgeons, it is important to make dentists aware of this condition since they may be the first clinicians to encounter patients with this abnormality.