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Unilateral cleft lip repair, over the last century, has seen both revolutionary changes and subtle technical refinements. Millard's rotation/advancement technique stands among the most striking of these innovations. We review the evolution of unilateral cleft lip repair including a look at straight-line, geometric and rotation/advancement type of repairs, while looking closely at the underlying theme of rotation and how common principles are evident in differing techniques. A review of how the medial cleft lip element is lengthened in these differing approaches illustrates common principles that, if learned and applied, will aid both the novice and experienced surgeon approach repair of the unilateral cleft lip in the lifelong quest of improved outcomes., (Copyright © 2010. Published by Elsevier Ltd.)

Tessier 7 clefts are a rare congenital anomaly, usually surgically repaired with Z-plasty or other reconstructive methods, although undesirable scars may result. We present a review of the literature and a case of unilateral Tessier 7 cleft repaired with a novel reconstruction technique using a combined Z-plasty and geometric broken line closure (GBLC) to camouflage and irregularize the otherwise linear scar. We present this case to expand the armamentarium of surgical options to address Tessier 7 clefts and to review techniques for repair. [ABSTRACT FROM AUTHOR]