Modified operation for wide unilateral cleft lips.

NUMEROUS procedures have been described for repair of congenital clefts of the lip. The older methods aimed at closure of the defect in primitive fashion, with insufficient regard for the cosmetic result. 1 From the time of Celsus until well into the 19th century, the operation consisted of an excision of the margins of the cleft and a crude approximation of the raw edges (Fig 1). Needless to say, failures were frequent. About 1830, Dieffenbach 2 introduced lateral undermining incisions to allow sliding of the flaps together with less tension. Mirault 3 is generally credited with having been the first, in 1844, to bring a flap from the lateral segment across the lower margin of the cleft, thereby adding improvement to the postoperative appearance of the lip (Fig 2). His method became the forerunner of various modern procedures. Numerous contributors have added their own modifications over the years. Collis improved