Cleft lip repair breakthrough—Dr.Millard.

In an era when individuals and even families (the Kardashian entourage)) overuse cosmetic surgery—and in many cases with questionable, even disastrous results—it’s important to remember the amazing things that reconstructive surgery (like cleft lip repair) can do. Both types of procedures are considered “plastic surgery.”

Plastic surgery to excess (check out the Kardashian crew): 

[NATL] Plastic Surgery: Celebrities Then and Now

Bruce Jenner BEFORE his/her final surgeries

Plastic Surgery Gone Wrong:

[NATL] Plastic Surgery Gone Wrong

The infamous Cat Woman.


Cleft lip repair innovator.

While I’ve blogged about face transplants and other major reconstructive procedures, I’d like today to honor the man responsible for the breakthrough “Z” surgery that revolutionized cleft lip repair. Many cleft lip and palate patients, myself included, might’ve benefitted from the innovative  repair technique Dr. D. Ralph Millard introduced in the 1950s. 
Blsck n white photo of Dr. Millard (left) examining Asian cleft lip patient.

Dr. Millard (left) with cleft lip patient.


According to Wiki, “Dr. Millard was chief of the Division of Plastic Surgery at University of Miami’s Miller School of Medicine for 28 years, and maintained a private practice in Miami.

In 2000, Dr. Millard was nominated as one of 10 “Plastic Surgeons of the Millennium” by the American Society of Plastic Surgeons. In the April 2000 issue of Plastic Surgery News, Dr. Millard was described as ‘the most brilliant and creative plastic surgeon we have alive. His work and publications speak for themselves.’  He is considered to be one of the founders of modern reconstructive facial surgery. See also The paramedian forehead flap

Millard was born in St. Lous, Missouri. He played football at Yale, where future president Gerald R. Ford was assistant varsity coach, studied medicine at Harvard Medical School in 1944, and interned in pediatric surgery at Boston Children’s Hospital. A U.S. Navy veteran, he served stateside in WWII and in Korea* during the Korean War, where he became interested in local children with cleft lips. 

The Millard cleft lip procedure.

The rotation-advancement procedure for cleft lip repair, also known as the Millard Repair, is designed to create a softer, more natural-looking lip. Surgery performed prior to the Millard procedure involved pulling both sides of the cleft lip together resulting in a tightly closed upper lip. The Millard Procedure rotates the tissue and creates a “Z” shaped scar instead. The “Z” shape gives the tissue more elasticity, resulting in greater flexibility and restoration of the Cupid’s bow

One of Millard’s students Anthony Wolfe says “Millard’s year in Korea is legendary. There was a lull in the fighting, and he developed an active reconstructive surgery service, caring for Korean soldiers from both sides of the conflict… He told the story of his conception of the rotation advancement procedure; he was looking at a picture of a patient with a cleft which he had placed up on an easel, and as he was dozing off, he said he had an Ah Ha moment where he visualized the procedure, and then marked on the picture the incision lines for the rotation-advancement repair. Another story, perhaps embellished, is that he found his first patient for the procedure in a rice field, and captured him with a lasso, having learned a number of rope tricks during his time in Houston.”



To learn about CLEFT HEART: Chasing Normal, click the Amazon or Barnes & Noble buttons in the margins. Or click the image of the book cover. My coming-of-age memoir has intertwining love stories, mystery, tragedy, and triumph.


  1. There is always a risk that something might go wrong like in any other medical procedure. The great surgeons though eliminate this risk to almost zero using the techniques and equipment appropriate to each particular case

    • So right you are. I bet some of the ability to choose the right approach comes from (unlucky for the surgeon?) numerous repetitions of similar procedures (lucky for pts). My 1st few
      surgeries were done during WWII and my 60+ y.o.doc had yrs.of cleft repairs under his belt…and wasn’t drafted like younger surgeons.

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