The characteristic features of patients with residual deformities after repairs of bilateral cleft lip by Manchester's cheiloplasly are well known. In this article, we report a technique according to Mulliken's design to fulfill the criteria of (1) a good color match and full vermilion in the midline, (2) midline orbicularis union, (3) narrowing of the prolabium and delineation of the natural cupid's bow, and (4) deep labial sulcus.We evaluated 10 cases of bilateral cleft lip deformity after Manchester's cheiloplasty. The patients,complaints were whistling deformities, vermilion color mismatch, wide and long prolabium, and so on. Except for the cases of tight lip deformity, there is excessive tissue in the central lip which creates stupid-like appearance in bilateral cleft lip patients. Resection of the residual prolabial tissue except for the philtrum and advancing the lateral segments to the midline could simultaneously improve various secondary deformities. Moving the central vermilion posteriorly enabled deep vestibuloplasty. We could obtain satisfactory results in all cases, but longitudinal observation is necessary in growing patients.
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