Background: Short columella and dropped tip are frequent findings in the cleft lip nasal deformity. Many techniques have been utilized to correct these deformities.

Objectives: This study proposes a novel inverted Incision and fibrofatty flap technique for Columellar lengthening and more tip definition, design of this study is a case series study.

Methods: The study evaluates objectively and subjectively the safety and outcome of this technique. A preliminary study that includes 8 patients (2 female, and 6 male) were presented with post bilateral cleft lip nasal deformity, main outcome Measures: Short columella and dropped tip was improved with improved functional and Aesthetic outcomes.

Results: The functional and aesthetic outcomes were highly improved with the proposed technique. The Confidence interval reached 98%, Most patients were most satisfied with their postoperative results when measured by the visual analog scale (VAS), with the dorsum, uneven alar bases, and the nostril coming in close behind. Each of the patients was happy with the results of the procedure, and several even said they would have it done again in the future if required.

Conclusion: The proposed technique could be a reliable and valuable alternative tool to improve the depressed tip and short columella in bilateral cleft lip nasal deformity.