In cleft lip repair surgery, the last problem to be solved is the nasal deformity. Since the nasal development does not reach the adult level until after the age of 15, the complete repair of the nasal deformity is not really completed until after adolescence, when young boys and girls have entered a period of concern for their own image and have a strong love of beauty. However, what criteria can be used to judge the final result of the repair of nasal deformity secondary to cleft lip? Some may say that the criterion is “back to normal or as normal as normal”. This is a common request made by patients to doctors. However, this request is only a general and unworkable expectation, which cannot be transplanted to the clinic. Therefore, a smart patient should not set his treatment goal as “normal”, and a smart doctor should not promise to make a deformed nose “normal”, because “normal” is a ray, and neither you nor the patient know where it stops. So, is there no criterion to determine the effectiveness of the repair of cleft lip and nose deformities? Of course not. According to the principle of symmetry, the effect of the repair of nasal deformity can be judged from the following aspects. 1. Whether the base of the nose is equal and symmetrical. Due to the effect of cleft lip on facial development, patients with unilateral cleft lip often have a certain degree of dysplasia on the affected side. The manifestation at the base of the nasal wing is the recession and depression of the lesioned side. If both sides of the nostrils are viewed as two adjacent houses, it is a house with a high wall base on one side and a low wall base on the other. In the repair of nasal deformity, it is an important step in the repair of nasal deformity to tamp the low side of the base and raise it. Therefore, whether the base of both sides of the nose is equal and symmetrical after surgery should be the first criterion in determining the effect of nasal deformity repair. 2, whether the nasal wing shape is symmetrical. One side of nasal collapse is the most obvious secondary deformity of unilateral cleft lip, and it is also an important repair content of cleft lip nasal deformity repair. If the surgery of cleft lip and nose deformity is regarded as the repair of a wooden house, then the repair process is to complete the reconstruction of this wooden house by means of lifting, suspending, supporting and anchoring. The important point whether this wooden house is really exquisite in the end is whether the roof is symmetrical or not, because it is the first thing we can see. As far as the surgically repaired nose is concerned, if both sides of the nose are symmetrical when viewed from the front, it can be considered to have achieved a better repair effect. 3.Bilateral nostril symmetry. This is the most difficult goal to achieve in unilateral cleft lip nasal deformity repair. As a spatial structure, the morphology of the nostrils is enclosed by the surrounding solid structures. In patients with cleft lip nasal deformity, the nostrils are often extremely asymmetrical bilaterally because of the abnormalities in the solid structures such as the nasal wing, nasal columella, and nasal base. Since the symmetry of the nostrils is achieved through the repair and adjustment of the surrounding solid structures, and it is difficult to repair all structures at the same time in one surgery due to various factors, the repair of nostril symmetry is usually accomplished after several surgeries, and in some cases, it can never be achieved. However, if the nostril is symmetrical after surgery, it means that the repair of nasal deformity has been perfectly concluded. 4. Whether the base of the nasal columella and the base of the nostril are symmetrical. Same as the nasal base, the base of nasal column and nostril base of unilateral cleft lip patients also have deformities such as dysplasia and depression, especially the base of nasal column, whose position deviation and dysplasia are often important factors causing nostril asymmetry, therefore, although these positions are not prominent, they are also parts that cannot be ignored in the repair of cleft lip nasal deformity. The perfection of the repair of cleft lip and nasal deformity will also be well reflected in the symmetry of these areas. In the case of nasal deformities, the type and degree of cleft lip varies, as does the degree of deformity, the problems that need to be addressed and the problems that can be addressed. Therefore, the standard of symmetry in each area is not completely and absolutely achieved in all patients after surgery. It is good enough to achieve the basic symmetry of each structure and not to detect the presence of deformity without careful observation, so why insist on “normal” which is not perfect! Pre-operative Post-operative