Bilateral cleft lip deformity results from failure of fusion between the frontonasal and maxillary processes during the fourth to seventh weeks of gestation. The deformity may be complete or incomplete and is often symmetric, unlike unilateral cleft lip. In this report, technical details of bilateral cleft lip repair are described in a 4 month old male.

Children with bilateral cleft lip and/or palate may undergo early intervention with presurgical orthodontics, upper lip taping, or bilateral lip adhesion. Definitive cleft lip repair usually takes place between 3 and 6 months of age, barring co-morbidities or other life-threatening conditions. Surgical details are thoroughly described.

Surgical goals were achieved: (1) symmetric and well-balanced upper lip, with recreation of Cupid's bow and philtral columns, (2) reconstitution of orbicularis oris muscle, and (3) symmetric alar bases with nares of equal size and shape. A tight, constricted appearance of the upper lip and nose is commonly seen. Total operative time was 2.5 hours and was accompanied by bilateral tympanostomy tube placement by an otolaryngologist. The child was extubated at the conclusion of surgery and began feeding immediately with a Haberman nipple. After an overnight stay to ensure adequate feeding, the child was discharged home with one week followup.

Bilateral cleft lip repair can be accomplished predictably and with high reproducibility. Primary rhinoplasty should be limited and should avoid placement of incisions along the nasal rims, lateral to the nose, or along the columella.