Primary Bilateral Cleft Lip/Nose Repair
The same surgical principle as for the unilateral cleft applies for the bilateral cleft lip, alveolus, and palate, and the results should be equivalent to those for the unilateral cleft lip. The fundamental aim of the repair of a 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. In this chapter the author introduces a step-by-step approach to the reconstruction of the lip and the nose that could be used in any bilateral case.
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