Bilateral Cleft Lip: Primary Repair

Primary bilateral cleft lip repair is among the most complex procedures in cleft surgery. Presurgical infant orthopedics address the prominent premaxilla and align alveolar segments for an optimal primary repair. Principles established by Mulliken have greatly increased the quality of bilateral cleft lip repair. These enduring principles emphasize symmetry, synchronous nasolabial repair, orbicularis continuity, proper philtral flap design, and median tubercle construction with lateral lip elements.