OBJECTIVE: Since 1991, a new method of repair of the complete bilateral cleft lip and palate has been performed. SUBJECTS AND METHODS: Nineteen patients were available for long term follow-up. The procedure is three stage after initial orthodontic management using the Latham appliance to align the premaxilla. At three months - bilateral closure from the buccal sulcus to the end of the primary palate with upturned flaps and bilateral buccal mucosal flaps. Six months - closure of lip with muscle reconstruction, closure of palate with muscle reconstruction of soft palate and nasal layer lengthening with a buccal myomucosal flap. Third stage, if necessary - lengthening of columella as indicated using central lip advancement flap. The follow-up concentrated on growth patterns and on nasal development. RESULTS: There was minimal growth retardation on follow-up. Lip development was more harmonious. Secondary procedures were few apart from columellar lengthening when necessary. CONCLUSION: This makes for easy closure of the most difficult area, since this was done when exposure is maximal. The lip and palate closure is lengthy but not difficult since segment alignment is satisfactory and there is minimal tension on the repair.