Correction of the secondary bilateral cleft lip deformity encountered in Guatemala.

C left care in Guatemala is not standardized or centralized in distinct cleft centers. Instead, most cleft care is offered through surgical missions by multiple surgical groups likely to have diverse training and expertise. This is particularly true in rural areas of Guatemala. Owing to the lack of locally trained cleft specialists, distance, and cost, patients rarely have the option of presurgical orthopedics. Given these circumstances, the variety and severity of secondary cleft deformities that are encountered are distinctly different from those presently encountered in the United States. The purpose of this study is to describe the secondary bilateral cleft lip (BCL) deformities encountered in Guatemala during the last 6 years and the surgical techniques that I have used for correction.