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The nasal deformities inherent in the cleft lip are challenging. Controversy exists regarding the best time to attempt surgical correction of this nasal problem. Opinion is now strengthening for the correction of these nasal deformities along with the repair of cleft lip either by a closed technique or by an open or external open tip rhinoplasty technique. Open tip rhinoplasty technique has the added advantage that it allows accurate repositioning and secure stabilization of the key anatomical structures such as the lower alar cartilages under direct vision, and the incisions of this procedure can be carried out through the hidden rim incisions of the nostrils without any residual scars. Following the introduction of open tip rhinoplasty at the time of lip repair in the cleft lip and palate patients by J.A. Trott and N. Mohan, it was decided to try this technique with minor modifications in our cleft lip and cleft palate management at the Department of Plastic & Reconstructive Surgery, Khoula Hospital, Muscat, Sultanate of Oman, since 1994, where over 75 new patients of cleft lip and palate are operated annually. Only unilateral and bilateral complete cleft lip with gross nasal deformities are selected for this study because nasal deformities are minimal in incomplete cleft lip. Conventionally, there is hesitation to do radical nose correction for the cleft lip patients because of the fear of possible growth retardation. The present technique, while it achieves excellent post operative results constantly, does not entail any more trauma to the cartilage complex than any of the conventional closed rhinoplasty techniques. Results obtained by this method appear to be superior to those by closed rhinoplasty techniques and there is no retardation of the nasal growth noticed.