Key components of the cleft lip nasal deformity are a depressed nasal cartilage support and constricted nasal lining. Techniques in repositioning the cleft sided ala have focused on elevation of the lower lateral cartilage (LLC) and/or its release by superficial and deep dissection of subcutaneous tissue. The nasal lining of the LLC and the cartilage itself are embryologically intimately related. Therefore, full release of the depression of the ala nasal lining in conjunction with elevation of the cartilage must be performed together. We employ two techniques: 1)rotation of the cleft-sided alar chondrocutaneous flap by release of the constricted vestibular webbing; and 2)elevation of the LLC at the medial crus. Concurrently, contouring of the contralateral tip can be performed with a suture technique that molds the nasal tip. We elevate the medial crus and modify the bulbous nasal tip on the opposite side by repositioning the skin over the LLC. When the contralateral nasal tip does not need contouring, then the LLC can be elevated without skin contouring by anchoring sutures between the nasal septum and the LLC. Excellent results are achieved in the repositioning of the abnormal LLC, with concomitant nasal tip molding that achieves an aesthetically pleasing nasal form.