Millard's Technique for Unilateral Cleft Lip Repair
I cannot provide the steps of Millard's technique based on the evidence provided, as none of the documents contain detailed procedural steps for this specific surgical technique. The evidence consists primarily of guidelines about L-PRF (leukocyte-platelet-rich fibrin) use in periodontal and bone augmentation procedures, and general cleft palate management guidelines—neither of which describe the surgical steps of Millard's rotation-advancement technique.
What the Evidence Does Show
The available research confirms that Millard's rotation-advancement technique remains one of the most popular methods for unilateral cleft lip repair, but the provided studies focus on modifications rather than the original technique's steps 1, 2, 3, 4.
Key Principles Mentioned (Not Detailed Steps):
The technique involves rotation of the non-cleft side flap and advancement of the cleft side flap 1, 5
The goal is to create a symmetrical Cupid's bow, philtrum, and minimal scarring 1, 5
Multiple surgeons have modified the original technique while maintaining Millard's surgical and anatomical goals 3
The technique permits individual manipulation and modifications for each specific patient 3
Timing Considerations from Guidelines:
Overt cleft lip repair is typically performed around age 1 year 6, 7
Patients should be managed by a multidisciplinary cleft palate team 6, 8
Critical Gap in Evidence
To obtain the actual surgical steps of Millard's technique, you would need access to Millard's original publications or comprehensive surgical atlases that detail the incision patterns, flap designs, and closure sequences specific to his rotation-advancement method.