Primary Unilateral Cleft Lip-Nose Repair

  • Nasser Nadjmi


The fundamental aim of the repair of cleft lip-nose deformity lies in the release of the abnormally attached and displaced anatomical structures, followed by meticulous realignment. The release must be sufficient to allow a tension-free closure for an optimal healing process. The closer and the more aligned these anatomical structures are, the less surgical release is necessary. This results in less scarring, and potentially more favorable growth is expected. Finally, a balanced lip and a symmetrically oriented alar base and lower lateral cartilage with normal tip projection must be achieved. There should be no vertical discrepancy between the affected and normal sides of the central philtral element. Thus, the normal anatomy should be recreated in four dimensions. The fourth one is the normal function.


  1. 1.
    Wong WL. History of Chinese medicine. Shanghai: Mercury Press; 1936.Google Scholar
  2. 2.
    Mirault G. Deux lettres sur l’operation du bec-de-lievre. J Chir Paris. 1844;2:257.Google Scholar
  3. 3.
    Blair VP, Brown JB. Mirault operation for single harelip. Surg Gynecol Obstet. 1930;51:81.Google Scholar
  4. 4.
    Brown JB, McDowell F. Simplified design for repair of single cleft lips. Surg Gynecol Obstet. 1945;80:12–26.Google Scholar
  5. 5.
    LeMesurier AB. A method of cutting and suturing the lip in the treatment of complete unilateral clefts. Plast Reconstr Surg. 1949;4(1):1–12.CrossRefGoogle Scholar
  6. 6.
    Hagedorn W. Uber eine Modifikation der Hasenschartenoperation. Zentralbl Chir. 1884;11:756.Google Scholar
  7. 7.
    Adenwalla HS, Narayanan PV. Primary unilateral cleft lip repair. Indian J Plast Surg. 2009;42(Suppl):S62–70.CrossRefGoogle Scholar
  8. 8.
    Reddy GS, et al. Choice of incision for primary repair of unilateral complete cleft lip: a comparative study of outcomes in 796 patients. Plast Reconstr Surg. 2008;121(3):932–40.CrossRefGoogle Scholar
  9. 9.
    Tennison CW. The repair of unilateral cleft lip by the stencil method. Plast Reconstr Surg. 1952;9:115–20.CrossRefGoogle Scholar
  10. 10.
    Randall P. A triangular flap operation for the primary repair of unilateral clefts of the lip. Plast Reconstr Surg. 1959;23:331–47.CrossRefGoogle Scholar
  11. 11.
    Skoog T. Skoog’s methods of repair of unilateral and bilateral cleft lip. Cleft lip and palate. Boston: Little Brown; 1971. p. 288–304.Google Scholar
  12. 12.
    Millard DR Jr. A radical rotation in single harelip. Am J Surg. 1958;95(2):318–22.CrossRefGoogle Scholar
  13. 13.
    Millard DR Jr. Transactions of the 1st International Congress of Plastic Surgery, Stockholm. Baltimore: Williams and Wilkins; 1957.Google Scholar
  14. 14.
    Millard DR Jr. The evolution of its surgery. In: Millard Jr DR, editor. Cleft craft, vol. 1, the unilateral deformity. Boston: Little Brown; 1976.Google Scholar
  15. 15.
    Pfeifer G. Morphology of the formation of cleft as a basis for treatment. Treatment of patients with cleft lip, alveolus and palate: 2nd International Symposium, Hamburg; 1964.Google Scholar
  16. 16.
    Mohler LR. Unilateral cleft lip repair. Plast Reconstr Surg. 1987;80(4):511–6.CrossRefGoogle Scholar
  17. 17.
    Cutting CB. The extended Mohler unilateral cleft lip repair. In: Losee JE, Kirschner RE, editors. Comprehensive cleft care. New York: McGraw Hill Medical; 2009. p. 299–330.Google Scholar
  18. 18.
    Cutting CB, McComb H, Millard DR Jr, Noordhoff MS. The SmileTrain virtual surgery videos. Disk 1—unilateral cleft. New York: Smile Train; 2001.Google Scholar
  19. 19.
    Noordhoff MS. The surgical technique for the unilateral cleft lip-nasal deformity. Taipei: Noordhoff Craniofacial Foundation; 1997.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nasser Nadjmi
    • 1
  1. 1.Department of Cranio-Maxillofacial SurgeryUniversity of Antwerp, University Hospital Antwerp, ZMACK AssociationAntwerpBelgium

Personalised recommendations