The Millard rotation-advancement lip repair using accurate measurements

For many years a wide variety of surgical techniques for closure of unilateral cleft lip has been used. Still many surgeons prefer the Millard rotation-advancement lip repair because the surgical scar is masked in the filtrum crest and the nostril floor, and it improves the relationship of the alar base of the cleft side, producing harmonious symmetry of the nostril and the nostril sill. In addition, it uses and preserves the lip anatomy, returning lip tissue into its normal position, minimizing the amount of tissue that is discarded, and reconstructing the orbicular oris muscle. One of the major disadvantages of this procedure is the lack of accurate measurements. This article demonstrates that rotation-advancement lip repair can be performed with accurate measurements as in the Tennison-Randall lip repair and tends to invalidate the widely held belief that rotation-advancement lip repair is a "cut as you go" technique.