The Tessier number 7 cleft is a rare congenital anomaly making up between 0.3% and 1.0% facial clefts. When combined with a concomitant unilateral cleft lip deformity, we are only aware of 1 previously reported case. We report the presentation, treatment course and long-term follow-up of 3 patients with combined Tessier number 7 cleft, unilateral cleft lip and craniofacial microsomia. All patients received multidisciplinary treatment at our Craniofacial Centre with a minimum follow-up of 29 years. This study demonstrates the phenotype, treatment philosophy, lessons learnt, and principles of reconstruction from birth to adulthood in this patient subset.
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