Principles of Cleft Lip Repair

Cleft lip is the most common congenital facial difference, imposing a significant burden of care on patients and their families. With careful planning and the use of contemporary techniques, excellent restoration is obtainable even in the most challenging cases. This chapter reviews anatomic and functional sequelae of cleft lip nasal deformities and presents principles for their correction. Considerations include use of presurgical orthopedics, timing and sequencing of repairs, and optimal employment of the various surgical techniques. We view cleft lip and nasal disharmonies together, describing extent of and techniques for nasal repair coincident with primary lip repair. Knowing predictable sequelae of primary repair may enable the cleft surgeon to minimize the need for secondary corrections. Nonetheless, when necessary, we also review principles in timing and technique for cleft lip revision.