Fig. 1.

Critical points for the surgical markings (Byrd repair). X, Vertical height of the upper lip; 1, midline point on the vermilion border of the prolabium, corresponds to the trough of the Cupid's bow peak; 2 and 3, Cupid's bow peak points on the vermilion border of the prolabium; 2^' and 3^', columellar base points; 4 and 5, corresponding Cupid's bow peak points on the lateral lip element marked at the area of greatest fullness of the dry vermilion; 6 and 7, upper lip points on the lateral lip elements—these correspond to the columellar base points during closure; 8 and 9, alar base points; 8^' and 9^', new alar base points if there is excess vertical height on the lateral lip element—this necessitates a crescentic wedge excision of skin if encountered. (Reproduced with permission from Byrd HS, Ha RY, Khosla RK, Gosman AA. Bilateral cleft lip and nasal repair. Plast Reconstr Surg 2008; 122(4):1181–1190).