The importance of the musculus nasalis and the use of the cleft margin flap in the repair of complete unilateral cleft lip.

The deformities of the lip and nose in cleft lip patients are intimately inter-related and their repair should not be independent procedures. The reconstruction should be dynamic, taking into account the different functions of the groups of the perioral musculature. For the lip repair, attenuation of the musculus nasalis of the sound side and the formation of the levator sling are believed to be important. Nasal repair consists of upward transpositioning of the origin of the musculus nasalis and of plicating the nasal fascia, followed by the transfer of the bi-lobed cleft margin flap to the piriform margin.