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Rotational Composite Flap Technique for Primary Incomplete Cleft Lip Nose Repair.

Percy Rossell-Perry^1,2

¹School of Human Medicine, Peruvian University Union (UpeU), Lima, Peru.

Annals of Plastic Surgery

|June 26, 2026

Summary

This study evaluates a rotational composite flap technique for primary cleft rhinoplasty in infants. The method shows promising results for nasal symmetry, with few patients needing further surgery.

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Area of Science:

Plastic Surgery
Craniofacial Surgery
Pediatric Surgery

Background:

Primary cheilorhinoplasty is favored for improved outcomes and reduced revisions.
The rotational advancement concept was initially for secondary cleft nasal deformity.
A novel technique uses medial rotation of a vestibular flap without donor site grafting.

Purpose of the Study:

To evaluate the long-term outcomes of a specific unilateral primary cleft rhinoplasty technique.
To assess nasal symmetry achieved with the rotational composite flap method.

Main Methods:

Retrospective cross-sectional study of patients with unilateral incomplete cleft lip operated between 2016-2018.
Follow-up of at least 5 years to assess nasal symmetry.
Analysis of photographic records by three independent observers.

Keywords:

cleft rhinoplasty incomplete cleft lip primary cleft nose repair unilateral cleft lip nose

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Main Results:

Eighty-five patients underwent surgery, with a median age of 3.8 months.
Nostril height symmetry achieved in 71.42% of evaluated patients (35/49).
Lip width symmetry achieved in 77.55% of evaluated patients (38/49).

Conclusions:

The rotational composite flap is a viable method for unilateral primary cleft rhinoplasty.
A low incidence of secondary surgical correction was noted during mixed dentition.
Further long-term comparative studies are needed to validate these findings.