title: Asymmetric bilateral cleft lip:  classification and a surgical technique.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the symmetry in lip height after using our technique for bilateral cleft lip repair. A retrospective audit of 1 surgeon's outcome of 35 consecutively performed bilateral cleft lip repair with asymmetry between the right and left segments of the lip. Data were from the Outreach Surgical Center Program Lima Peru.
  
  
  METHODS
  Since 2007, 158 patients with bilateral cleft lip were operated on using the Outreach Surgical Center Program Protocol. Of these patients, 35 (repaired using our technique) met the study criterion of having anthropometric measurements performed at least 1 year after surgery. Under general anesthesia, collection of lip height data (right and left sides) was performed immediately before the lip (before surgery) and palate (after surgery) surgery. Lip measurements were obtained using calipers.
  
  
  RESULTS
  A 2-sample t-test with equal-variance analysis was performed to assess the statistical significance of differences between the right and left sides of the lip after surgery. This study found no statistically significant differences between the height of the right and left sides of the lip (P = 0.12) after lip repair using our technique.
  
  
  CONCLUSIONS
  These findings suggest that this technique is a good alternative to repair asymmetric forms of bilateral cleft lip. The operative strategy for repair of an asymmetric bilateral cleft lip is determined by the degree of severity of the cleft.
authors.affiliation: Outreach Surgical Center Lima Peru ReSurge USA. prossellperry@gmail.com
authors.forename: Percy
authors.initials: P
authors.lastname: Rossell-Perry
authors.forename: Arquímedes M
authors.initials: AM
authors.lastname: Gavino-Gutierrez
mesh_terms: D000886:Anthropometry; D002971:Cleft Lip / Q000145:classification* / Q000601:surgery*; D005146:Facial Asymmetry / Q000145:classification* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome