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The 3-line Algorithm for the Treatment of Bilateral Cleft Lip
Franklin J Paredes1, Valerie K Paredes2, Emily M Jones3
1From the Department of Plastic Surgery, Ecuadorian Social Security Institute, Carlos Andrade Marin Hospital, Quito, Ecuador.
Plastic and Reconstructive Surgery. Global Open
|February 27, 2026
Summary
A new 3-line algorithm for bilateral cleft lip (BCL) repair effectively reduces complications. This approach improves both the functional and aesthetic outcomes for patients undergoing BCL treatment.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Bilateral cleft lip (BCL) repair is complex, with outcomes influenced by cleft severity and treatment protocols.
- Achieving aesthetic harmony and avoiding complications requires a coordinated approach.
- Current treatment strategies necessitate refinement for optimal BCL repair outcomes.
Purpose of the Study:
- To design and implement a clear algorithm for measuring BCL severity.
- To apply a refined surgical technique for improved BCL repair outcomes.
- To reduce complications associated with bilateral cleft lip repair.
Main Methods:
- Retrospective analysis of 22 BCL patients' records (Jan 2021-Dec 2022) from Operation Smile.
- Prospective application of a newly developed 3-line algorithm to 21 BCL patients (Jan 2023-Dec 2024).
- Correlation of clinical data, treatment protocols, surgical techniques, and patient evolution.
Main Results:
- The retrospective analysis informed the development of the 3-line algorithm.
- Application of the algorithm in the prospective cohort led to a decrease in complications.
- The algorithm demonstrated applicability and viability in BCL treatment.
Conclusions:
- Cleft severity is crucial in planning BCL treatment and preventing complications.
- The 3-line algorithm significantly reduces complications in bilateral cleft lip repair.
- Improved function and aesthetic results were observed in patients treated with the algorithm.
