Clinical Management of BCLP with a Severe Hypoplastic and Retruded Premaxilla

Bilateral cleft lip and palate with a severe hypoplastic and backward rotated premaxilla and lack of soft tissues is a rare congenital facial deformity. No treatment protocol for this type of cleft is widely accepted. In patient with bilateral cleft lip and palate, the premaxilla was protracted by nasoalveolar molding before lip surgery. The nasal tip was elevated and the columella lengthened by nasal components incorporated into the palatal guidance plate. After 4 months of nasoalveolar molding, surgery could be performed without complications. Postoperative use of a guidance plate prevented relapse of the premaxillary segment, the nasal conformers maintained the nostril form.