"The first time is the best time."

Favorable initial cleft lip and nose repair is critical in providing patients with optimal long-term form and function. Current "cut as you go" techniques of cleft lip repair rely heavily on the abilities and experience of surgeons, and the myriad of variations reflects the free-form nature of those repairs. The lack of more defined methods can make cleft lip repair intimidating for new surgeons and can result in variability of outcomes for more experienced surgeons. The "Anatomic Subunit Approximation Approach" to cleft lip repair relies upon anatomic landmarks and anatomic subunits in the design of a cleft lip repair. It involves careful measurement and includes ways to check and recheck the design to help surgeons achieve favorable form. Studies have demonstrated optimal results without the learning curve that other techniques require. Because the approach is based on landmarks, it inherently adapts to all presentations. Although the technique has been widely adopted, the many landmarks and measurements make it seem complex. The purpose of this session is to describe the Anatomic Subunit Approximation approach to cleft lip repair and demonstrate how it adapts to various presentations to produce favorable results.

We will use step-by-step explanations to illustrate and clarify the approach. We will use case examples that span the spectrum of presentations from complete to microform clefts. We will describe ways to verify and adapt the repair for final tailoring so that there is some flexibility in final repair. We will use a combination of photos, videos, illustrations, and discussions to ensure that attendees benefit from the session. Even if more experienced surgeons do not adopt the technique, an understanding of the approach can help with the non-overt landmarking that occurs with cut-as-you-go repairs. Careful planning makes for accurate and efficient repair and that ultimately benefits our patients!

Continuing Education 

Attendees must register, attend and evaluate each webinar to receive continuing education credit. This on-demand course will be eligible through October 2, 2020. 

  • ACCME: ACPA designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should only claim credits commensurate with the extent of their participation in the activity. The American Cleft Palate-Craniofacial Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Seminar Objectives
  • The learner will be able to design incisions for optimal repair.
  • The learner will be able to identify landmarks for cleft lip repair.
Seminar Information
Expiration Date:
September 02, 2020 11:55 PM
1 hour
Cleft Lip Repair: Measure Twice Cut Once
Speaker Information
David M. Fisher MD  [ view bio ]
Raymond Tse MD  [ view bio ]
Individual topic purchase: Selected
AMA PRA Category 1 Credit(s)™: 1.00
Accreditation Council for Continuing Medical Education (non-MD/DO)
AMA PRA Category 1 Credit(s)™: 1.00
On Demand Only
ACPA Life Member: $24.99
ACPA Member: $24.99
ACPA Retired: $24.99
Member: $24.99
Student Member: $24.99
Student Non-member: $24.99
Transitional Member: $24.99
Full Price: $34.99