The surgical technique for the complete unilateral cleft lip-nasal deformity

Primary Overcorrection of the Unilateral Cleft Nasal Deformity

“…4,15,19 In the evolution of cleft lip and nose deformity surgery in our institution, we moved from a protocol without primary nasal recontruction to a second one in which the nose was adressed, but the patients had to have secondary nasal reconstruction in the growing period due to insufficient primary repair. We also have observed that the secondary rhinoplasty procedure in the growing period may not guarantee longlasting results.…”

Changes in lip 1 year after modified Millard repair

“…The point has different definitions in the literature: NOORDHOFF 13 marked the lateral point of the base of the philtral column by identifying the great- est width of the vermilion border across from the white roll. It was difficult, subjective and inaccurate to identify the greatest width of the vermilion border when analyzing the photos.…”

Unilateral Cleft Lip Repair Using the Anatomical Subunit Approximation

“…The nasal floor is fully closed to the level of the incisive foramen and the nasal sidewall is reconstructed with a turbinate flap, 8,15 L-flap, 21 or lateral nasal wall advancement. 2 These have been previously described in further detail 2 and are summarized in Figure 2.…”

“…3,4 Millard's rotation advancement 5 and its modifications [6][7][8] involve a "cut-as-you-go" approach that can be prone to surgeon ability and experience and has been criticized for producing short lips when used for wide clefts. [9][10][11] The TennisonRandall repair is more geometric and is thought to be easier to learn 12 and more suitable for wide clefts 13 ; however, the resultant scar inevitably crosses natural contours.…”