Abstract
BACKGROUND
Outcomes after primary unilateral cleft lip repair remain variable despite advances in surgical technique. Beyond operative design, long-term results appear influenced by growth, deformity severity, and surgical decision-making, factors that have received comparatively less attention in the literature.
METHODS
A deformity-based decision approach to primary unilateral cleft lip repair is described and illustrated through a retrospective review of a consecutive single-surgeon cohort. Clinical records and standardized photographs were reviewed descriptively to examine how deformity characteristics informed operative planning, postoperative management, and early clinical outcomes during available follow-up.
RESULTS
Restoration of continuity across lip and nasal components produced generally balanced early lip-nasal relationships, supported by objective subset-level photogrammetric measurements demonstrating near-symmetric lip height and preserved nasal base alignment. Early postoperative symmetry did not reliably predict subsequent growth-related change. Primary nasal correction focused on alignment and structural support rather than cartilage reshaping, allowing early symmetry while preserving flexibility for later revision. Secondary procedures occurred more often in more severe clefts, suggesting revision patterns were primarily related to deformity severity rather than operative technique. Postoperative scar care and selective nasal conformer use supported scar maturation and contour stability but were not essential for achieving balanced primary repair.
CONCLUSIONS
Primary unilateral cleft lip repair may be best viewed as deformity-guided longitudinal planning rather than the pursuit of immediate aesthetic perfection. A component-based approach links preoperative assessment with expected growth and supports structured, reproducible surgical decision-making.
TY - JOUR
T1 - Primary Unilateral Cleft Lip Repair: A Deformity-Based Approach.
AU - Allam,Karam,
AU - Haredy,Mostafa Mamdoh,
AU - Bakri,Sherif,
Y1 - 2026/06/02/
PY - 2026/04/16/received
PY - 2026/05/06/accepted
PY - 2026/6/2/medline
PY - 2026/6/2/pubmed
PY - 2026/6/2/entrez
KW - Cleft lip
KW - nasal deformity
KW - postoperative care
KW - primary repair
KW - surgical restraint
KW - unilateral cleft lip
JF - The Journal of craniofacial surgery
JO - J Craniofac Surg
N2 - BACKGROUND: Outcomes after primary unilateral cleft lip repair remain variable despite advances in surgical technique. Beyond operative design, long-term results appear influenced by growth, deformity severity, and surgical decision-making, factors that have received comparatively less attention in the literature. METHODS: A deformity-based decision approach to primary unilateral cleft lip repair is described and illustrated through a retrospective review of a consecutive single-surgeon cohort. Clinical records and standardized photographs were reviewed descriptively to examine how deformity characteristics informed operative planning, postoperative management, and early clinical outcomes during available follow-up. RESULTS: Restoration of continuity across lip and nasal components produced generally balanced early lip-nasal relationships, supported by objective subset-level photogrammetric measurements demonstrating near-symmetric lip height and preserved nasal base alignment. Early postoperative symmetry did not reliably predict subsequent growth-related change. Primary nasal correction focused on alignment and structural support rather than cartilage reshaping, allowing early symmetry while preserving flexibility for later revision. Secondary procedures occurred more often in more severe clefts, suggesting revision patterns were primarily related to deformity severity rather than operative technique. Postoperative scar care and selective nasal conformer use supported scar maturation and contour stability but were not essential for achieving balanced primary repair. CONCLUSIONS: Primary unilateral cleft lip repair may be best viewed as deformity-guided longitudinal planning rather than the pursuit of immediate aesthetic perfection. A component-based approach links preoperative assessment with expected growth and supports structured, reproducible surgical decision-making.
SN - 1536-3732
UR - https://www.unboundmedicine.com/prime/citation/42228504/Primary_Unilateral_Cleft_Lip_Repair:_A_Deformity-Based_Approach.
DB - PRIME
DP - Unbound Medicine
ER -
