The reconstruction of a symmetrical bilateral cleft lip and a natural looking nose with adequate columella length is a difficult challenge. The integrated multidisciplinary approach with presurgical nasoaveolar molding, modification of surgical techniques, and postoperative scar management and maintenance of the reconstructed nasal shape can give a more consistent better result. Better understandings of the primary pathology and refined surgical technique have resulted in a decrease of severity in secondary deformities and the classic stigmata of the repaired cleft. The key surgical principles and steps are presented in this chapter.
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