Primary repair of the bilateral cleft lip nose: a 15-year review and a new treatment plan.
 For 15 years a forked flap has been used for columella reconstruction in primary repair of the bilateral cleft lip nose.
 With the adolescent growth spurt, three unfavorable features have become apparent: (1) the columella may grow too long and the nostrils too large, (2) often the nasal tip remains broad, and (3) there is a drift of the columellar base and the lip-columellar angle is transgressed by scar.
 This procedure has therefore been discontinued.
 A new treatment plan is presented in which the columella is reconstructed from tissues in the splayed-out nasal tip.
