Transverse facial cleft repair using a small triangular flap technique.

Transverse facial cleft is a rare congenital malformation frequently associated with anomalies of the first and second branchial arches. We report a case of transverse facial cleft repaired using a small triangular flap technique designed to improve aesthetic and functional outcomes while minimizing scar formation. A 5-day-old infant presented with a right transverse facial cleft and bilateral accessory auricles without additional anomalies. Surgical repair was performed at 5 months of age. A 2-mm triangular flap was designed at the commissure, followed by excision of redundant skin and mucosa. Careful dissection and overlapping of the orbicularis oris muscle were performed to prevent thinning of the muscular layer. Commissure reconstruction was completed using a straight-line closure. At the 2-year follow-up, satisfactory aesthetic and functional outcomes were observed without major complications. This technique may provide favorable commissural morphology with minimal scar formation in transverse facial cleft repair.