Fundamentals of Secondary Correction of Unilateral Cleft Lip and Cleft Lip-Nasal Deformities

Optimal correction of the unilateral cleft lip and associated nasal deformity is performed at the time of primary repair. With growth of the nose, persistent pathology is accentuated, and secondary surgery is almost universally expected. Additionally, limitations of primary surgical techniques, suboptimal execution, and poor healing can result in a plethora of secondary deformities that benefit from revision surgery. Optimal restoration of secondary cleft lip and nasal deformities requires correct diagnosis, understanding of their anatomic cause, prescription of the correct surgical treatment, and intervention at an appropriate time that accounts for growth and the psychosocial needs of the patient and family. This chapter will consider the primary deformities associated with the unilateral cleft lip and secondary deformities that may arise from surgical repair, consider the anatomic causes of these deformities and will offer surgical remedies for their correction as well as a framework for consideration of appropriate timeline for their treatment.