Two sisters with unoperated bilateral cleft lip and palate, age 6 and 4 years

Two sisters with unoperated bilateral cleft lip and palate, aged 5 years 8 months and 3 years II months, are described. The degree of premaxillary protrusion in both was similar to that in unoperated infants. On the other hand, children operated in infancy showed less midfacial protrusion than the sisters following repair of their lips at a later age suggesting that the repaired lip has a long-acting effect in restricting growth of the premaxillary-vomerine complex. Later, forwards growth of the mandible and elongation of the face also serve to minimise the convexity due to the projecting premaxilla.