Nasal shape differences are common in people who are born with a cleft. In years past, the standard of care was to do little to the nose at the time of infant lip repair because of concerns of disturbing nasal growth. Left untreated, the resultant nasal difference was often quite severe and difficult for the affected child. Fortunately research studies revealed surgical correction of the nose at the time of infant lip repair did not harm growth and the resultant nasal difference was much milder. Further research revealed that the infant cartilage can be molded during the first six weeks of life. Cartilage molding has been used to correct external ear irregularities for several years.

This technique has also been applied to children with cleft lip, to influence the shape of their nose prior to the initial surgery. This further improves nasal shape and alveolar position.

A range of molding techniques is used depending on the extent of the cleft. A prefabricated conformer held with special tape is often effective. Sometimes custom appliances are made in conjunction with an orthodontic type retainer.