The goal of this study is to address the soft tissue element of this deformity (in addition to the essential skeletal element) and evaluate its value in the final outcome. Soft tissue element includes modifying the shape of the nostril by direct incisions and augmenting the nasal sill by composite grafts. The current study is a randomized controlled trial study performed. Twenty patients with unilateral cleft lip nasal deformity were included during the period from November 2016 to December 2018. Patients were recruited from Otorhinolaryngology outpatient clinics in Beni-Suef University Hospital and randomly allocated into two groups: group (A) included 10 patients underwent skeletal reconstruction only (standardized technique), while group (B) included 10 patients underwent, in addition to skeletal reconstruction, and soft tissue manipulation (the new technique). The results showed that there was no statistical difference between both groups regarding hemicolumellar length, hemitip height, alar width length and domal angel. Linear and angular measurements showed improvement in both groups without difference.  Subjectively, patient satisfaction and peer review showed no significant difference.