Bilateral cleft lip

This article reviews the principles that guide repair of bilateral cleft lip with emphasis on primary nasal correction and the role of preoperative dentofacial orthopedics. The article details the author's method for synchronous closure of the complete deformity and less uncommon anatomic variations. The author underscores the three-dimensional adjustments that are needed because of predictable four-dimensional changes. The obligation for periodic assessment of these children is stressed and the available methodologies are considered. Nasolabial appearance and speech are the foremost priorities in habilitation of the child with bilateral cleft lip/palate. Maxillary retrusion is a consequence of labiopalatal repair and often requires correction in adolescence.