A technique of a one-stage repair of soft tissues in severe bilateral cleft lip without presurgical orthodontics or lip adhesion.

The repair of severe bilateral cleft lip is usually done electively at three months after orthodontic appliances have pushed back the protuberant premaxilla to its expected position in the dental arch shelves. Historically the premise that the repair will break down or that the premaxilla will not recede has been challenged. This paper describes a technique that the author has used as a one-stage 'putting it all together' repair without presurgical orthodontics or lip adhesion. The results have been favourable and may bring about a rethink on the tissues' inherent plasticity, the need for early orthodontics and the effect of a muscular strut as an effective substitute for artificial appliances.