Bilateral cleft nasal repair

In spite of recent advances and innovations in the management of the bilateral cleft lip nasal deformity, no single surgical technique has gained widespread acceptance. Criteria for an ideal approach should include the following: aesthetic and physiologic factors, low complications and technical demands, minimal scarring, unimpaired future growth, and a reasonable burden on patients and caregivers. This article reviews several procedures for bilateral cleft lip nasal correction emphasizing the advantages and disadvantages of each. Particular attention will be given to the forked flap technique of Millard and newer methods utilizing tissue in the nasal tip with or without prosthetic treatment.