A method of bilateral cleft lip nose repair--a preliminary report.

By redefining the surgical anatomy of the nose, we were able to develop a new technique for the repair of the bilateral cleft lip nose. The lower one-third of the nose was divided into an outer layer, composed of skin, and an inner composed of fascia, muscle, cartilage and the skin of the vestible. From this viewpoint, the bilateral cleft lip nose deformity was reinterpreted as a combination of dislocation and deformity of the inner layer, and rotational displacement of the inner layer with respect to the outer layer. Using the double alar wing flap incision, we were afforded good visualization and anatomic reconstruction without tension by rotating the inner and outer layers in opposite directions. The length of the columella, the alar facial angle, the width of the nose and the size of alae have been satisfactory in 6 patients.