Bilateral cleft lip repair

Repair of a bilateral cleft lip remains a big challenge. We describe our approach based on the bilateral cleft lip repair by Fisher. In this repair, the red lip is made from the lateral lip elements only, and continuity of the orbicularis oris muscle is achieved. Tips are given to avoid a whistle notch deformity or too much fullness of the median tubercle. The nose remains the main stigma for patients with complete bilateral lips, deserving an equal amount of attention as the lip during the repair. A method for optimal primary correction is presented, while avoiding additional scars and damage that will complicate later surgery. The rotation of C-flaps from the prolabium into the nostril sill can also help define the angle between columella and lip. Proper muscle release, repositioning, and approximation are the foundation of the lip repair