Background/Objectives: Primary cleft lip repair is a procedure to restore lip function and harmonious nasolabial appearance. However, the actual effects on nasolabial appearance have been insufficiently investigated. The aim of this study was therefore to critically review surgical results using well-validated objective and subjective methods and standardised outcome measures. Methods: A total of 26 non-syndromic patients with unilateral cleft lip +/− cleft palate were assessed retrospectively. Uniform 2D photographs of the nasolabial region were objectively analysed using SymNose software. The Cleft Aesthetic Rating Scale was employed for the subjective evaluation by a total of 255 observers with different backgrounds and experience levels in cleft surgery. Results: Significant positive correlation was identified between objective measurement of upper lip asymmetry and subjective assessment (p = 0.02). Furthermore, a significant difference emerged in the assessment of the nasolabial region depending on the rater’s professional background (p < 0.001). A major discrepancy was observed between the rating of maxillofacial consultants and those of laypersons and patients affected by cleft lip +/− cleft palate. Conclusions: The evaluation of attractiveness depends significantly on the professional background of the observer. The more interaction people have with individuals after cleft lip repair, the less they consider the aesthetics conspicuous. Achieving the highest possible postoperative nasolabial symmetry should be a main objective in primary cleft lip repair.

Bilateral sagittal split osteotomy is a commonly used, standard procedure in orthognathic surgery to correct malocclusion and jaw misalignment. Postoperative vascular complications are extremely rare and under-reported in the literature. This contribution presents the case of a 48-year-old male patient who underwent bilateral sagittal split osteotomy due to class II skeletal malocclusion. There were no abnormalities during the surgery. However, the patient developed facial palsy and experienced a pulse-synchronised murmur. Computed tomographic angiography (CTA) revealed an arteriovenous fistula between the right external carotid artery and the pterygoid plexus with pseudoaneurysm. Following the diagnosis, the patient was successfully treated with an intervention involving coiling and sealing with histoacrylic glue. It is crucial to be aware of serious vascular complications following orthognathic surgery, as a delay in diagnosis and treatment can lead to life-threatening bleeding or long-term damage. CTA is the most rapid and accurate method of confirming the diagnosis. If there is clinical suspicion, this examination should not be delayed, and the therapeutic approach should be determined on an interdisciplinary basis.