Primary repair of the bilateral cleft lip nose: a 4-year review.

Four years ago, a new method of primary repair of the bilateral cleft lip nose was described. The splayed-out alar domes and columellar crura that lie within the nasal tip were exposed by an open-tip rhinoplasty. They were united to re-form the columella and narrow the nasal tip. This report is the first stage of a longitudinal study of the nasolabial growth and development of the first seven consecutive patients who were treated by this method at Princess Margaret Hospital. At 3 to 4 years of age, the columellae are well developed, and there appears to be no interference with growth. The external nasal scars create minimal disfigurement.