Two-Stage Repair of Bilateral Cleft Lip: Indications for This Treatment Strategy

Background: The aesthetic outcomes of a bilateral cleft lip (BCL) are inferior to that of unilateral cases. With this in mind, the authors reviewed our BCL outcomes in patients having a 2-stage repair. Strategies in repair protocols may be employed to improve outcomes in a particular group of patients. Methods: All patients who had a 2-stage repair of BCL in the last 17 years were reviewed. This protocol strategy was specifically employed in patients who had a complete cleft lip on one side and an incomplete cleft lip on the opposite side. The complete side was repaired first followed by the incomplete side a minimum of 6 weeks later. The outcomes in patients undergoing the 2-stage repair in this cohort were assessed. There were 25 patients in this group with 15 males and 10 females. The age at the first stage ranged from 3 to 9 months. Results: It was found that the results in this group resulted in better aesthetic outcomes than patients who had a single-stage repair. There was less stigmata of a tension type repair and a more harmonious relationship between the upper and lower lips. Conclusion: It is recommended that a 2-stage strategy be employed in repair of BCL if one side is complete and the other is incomplete.