Cleft lip nose: a different approach.

The aim of this study is to demonstrate a different manner of treating cleft lip nose by approaching the problem at its origin, the nasolabial gap. The surgical technique we propose corrects the affected structures from the "bottom to the top." First we have to make sure that the orbicularis oris is well oriented, then we have to create space for the twisted alar cartilage, and finally we reach the tip of the nose with less asymmetry to correct, compared with previously published data. Before attempting any additions of grafts, implants, etc. for the restoration of any congenital deformity, especially clefts, the surgical team must try to reposition, reorganize, and reorient the structures affected by a lack of continuity or a gap as a result of the embryogenesis.