**Author details**

In my opinion, this technique yields very satisfactory results (**Figure 18**).

92 Designing Strategies for Cleft Lip and Palate Care

At Vermont State Cleft/Craniofacial Center, we perform formal NAM presurgical orthopedics only on children with bilateral clefts who have premaxillary protrusion (**Figure 5**). Unfortunately, we have found that the frequent visits and lack of insurance coverage for NAM result in a high burden of care for families in Vermont. Because of this, we have not adopted this modality for children with unilateral clefts. We have found presurgical taping (**Figure 4**) to be an efficacious yet inex‐ pensive modality and it offers an opportunity for parents to play an active role in their child's care.

**Figure 18.** (A) An infant with a wide, yet incomplete unilateral cleft lip. Note the narrow Simonart's band. (B) The infant

after a Pool midlip Z‐plasty and Powar vermillion flap repair. (C) The same child at 5 years of age.

Mustafa Chopan, Lohrasb Sayadi and Donald R. Laub\*

\*Address all correspondence to: Donald.Laub@uvmhealth.org

University of Vermont College of Medicine, Burlington, Vermont, USA
