The last issue of the Clinics in Plastic Surgery that Simultaneous correction of the coexisting nasal was devoted to the management of patients with clefts of the lip and palate was published over 10 years ago (October 1993). Since then, several advances, modifications, and refinements of surgical techniques and treatment protocols have been described and some studies with long-term results were published. Some surgical techniques were abandoned because of suboptimal long-term results, and some promising ideas (e.g., fetal correction of cleft lip) were not further pursued because of complex ethical implications and the potential high risk for the mother and the fetus. Preoperative orthopedic techniques with mostly passive but also active devices are currently widely used in preparation for unilateral and bilateral cleft lip repair. Thus skeletal relationships are improved preoperatively and the surgeon is given the opportunity to repair the lip under less tension and more optional conditions. Preoperative manipulations of nasal cartilages with naso-alveolar molding and other devices also gained some popularity and have been incorporated in some treatment protocols. Advocates of this technique have demonstrated that with these appliances the alar cartilages are slowly ‘‘molded’’ in a more favorable position facilitating the surgical correction of the nasal deformity. Drawbacks include additional expenses, multiple visits for adjustment, and the possibility of overstretching the nostril during treatment.