This topic sounds like a nonsense. Of course surgery is important for cleft lip patients, and it doesn’t matter which surgery is important and determines the patient’s future, so isn’t it both biased and boring nonsense for you to emphasize here that only the first surgery is important? No. When you see patients who are in their prime, sitting in front of them with sad faces, accompanied by equally sad parents, pointing to their children’s severely deformed upper lip for help, you may feel the importance of the first surgery, and how inadequate, superficial and biased our understanding of the importance of the first cleft lip surgery is. To discuss the importance of the first cleft lip surgery, it is important to know what the purpose of the first surgery is. This seems to be another idiotic question. Who doesn’t know that the purpose of cleft lip surgery is to restore a normal upper lip shape. No, this is a poignant and highly misleading unrealistic wish and should never be the purpose of cleft lip repair surgery. Even if it is the purpose of cleft lip repair, it should not be at the time of the first surgery, but at the time of the last repair of the secondary deformity of the cleft lip. The purpose of the first cleft lip repair should be to restore the continuity and integrity of the upper lip structure and to create a foundation and platform for the development of the upper lip that meets its basic biological requirements. Understanding the purposeful nature of the first surgery for cleft lip, its importance cannot be overstated. Cleft lip, especially the more severe third degree cleft lip, is never a single surgery that creates the ideal upper lip shape. It may take two or even three surgical repairs over the patient’s lifetime to achieve a better cosmetic upper lip result. The second, third or even more surgeries are done on the basis of the first surgery, therefore, the result of the first surgery almost determines the success or failure of the subsequent surgeries and also determines the final surgical repair cosmetic result of the patient, in this sense, the first surgery of the cleft lip patient is the most important surgery in the whole lifetime treatment process, the doctor’s understanding of this surgery, the concept of repair, and the patient’s family’s reasonable request for the surgical result. The reasonableness of the patient’s family’s request for the outcome of the surgery is important for the outcome of the surgery, and for the patient’s lifetime. However, due to some misconceptions, this important procedure often becomes a failure and leaves the patient with lifelong regrets. The most common of these is the surgical pursuit of the so-called normal upper lip or perfect upper lip shape rather than the restoration of the continuity and integrity of the upper lip, and the reckless removal of the precious upper lip tissue that should have been preserved, resulting in subsequent surgeries being trapped in a situation where the cleft has no rice. Therefore, to attach importance to the first repair of cleft lip, it is important to first properly understand the purpose of the first surgery, its significance and the measures that can be taken to achieve this purpose. It is not important for the patient to become an angel with a smile in one surgery, it is not important whether a high class surgery is used, it is not important whether he can enjoy free medical treatment, and of course it is better if all these can be achieved, what is important is what the surgery has left him and what it can bring to his future, after all, what we really expect is his future more than ten years later.