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52456 - Cleft Lip Flap Reconstruction (First Stage)

MBS service description:

Cleft lip reconstruction using full thickness flap (Abbe or similar), first stage (H) (Anaes.) (Assist.)
Schedule Fee:
942.5
@85% Benefit Fee:
@75% Benefit Fee:
Last updated on
March 29, 2025

When is item code 52456 (Cleft Lip Flap Reconstruction (First Stage)) typically used?

The need for cleft lip reconstruction using a full thickness flap (e.g., Abbe flap), first stage, arises when a patient with a severe cleft lip defect—often after failed prior repairs or significant tissue loss—requires a staged surgical approach under anesthesia with assistance in a hospital, using a flap from the opposite lip to rebuild the affected area, initiating restoration of lip structure and function. This is indicated for complex cases needing substantial tissue transfer, critical in the maxillofacial region where lip integrity affects speech, eating, and appearance.

Key conditions driving this procedure include:

  • Severe tissue loss: A wide cleft or failed repair might lack enough local tissue, needing a full thickness flap from the lower lip.
  • Functional deficit: Poor lip closure impairing speech or feeding prompts reconstruction.
  • Aesthetic need: Significant scarring or asymmetry requires a flap for better contour.
  • Staged repair: First stage sets up tissue transfer for later detachment.

For example, a young adult with a large unilateral cleft defect might need an Abbe flap from the lower lip to rebuild the upper, with assistance for precision. In aged care, an elderly patient could seek this for late-life function, given frailty. By initiating reconstruction, this service lays the groundwork for full lip restoration, enhances function, and improves aesthetics, making it a critical first step in complex cleft lip repair.

Benefits to the patient

Surgeons initiating cleft lip reconstruction with a full-thickness flap (e.g., Abbe) on the patient in the first stage under anesthesia with assistance provide foundational benefits. A key advantage is starting robust reconstruction. This stage sets up the patient’s lip repair with strong tissue—vital for 'Abbe flap benefits.' It also improves function by beginning the restoration process, preparing the patient for better capabilities. Furthermore, it sets up aesthetic repair by establishing a base, enhancing the patient’s eventual appearance. For surgeons exploring 'first-stage cleft reconstruction advantages,' this assisted service ensures patients benefit from a solid start, functional preparation, and aesthetic groundwork, offering a critical initial step in lip reconstruction.

Recovery considerations

Recovery of 2-3 weeks with swelling and flap care; hospital stay needed.

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