The surgical outcome of unilateral cleft lip (UCL) helps clinicians evaluate symmetry and aesthetics. Hence, this study aims to evaluate the factors associated with the outcome of UCL repair based on photographic analysis. This study comprised 125 patients with UCL who underwent primary surgery (cheiloplasty) and were followed for 1 month. Clinical outcomes were as follows: 1. No correction was required; 2. Corrections of the lip were only 3. Redo Cheiloplasty. Factors affecting treatment outcomes, such as time of surgery, surgical technique, centers, cleft side, and severity, were evaluated. Standardized digital photographs of the patients' full face were considered for outcome assessment. Postoperative outcomes varied significantly by surgical technique, center, and case severity. Millard's technique yielded superior results, with 44.3% requiring no correction compared to 21.1% for Afroze, while lip-only corrections were more frequent with the Afroze technique (47.3%) (p=0.019). Center 2 achieved the best institutional performance (46.2% no correction), whereas Center 3 had the highest rate of lip-only corrections (47.4%) (p=0.031). Severity was a major determinant, with mild cases showing 64.4% without correction and only 11.1% requiring redo cheiloplasty, whereas severe cases had 50.0% undergoing redo cheiloplasty (p<0.001). The present investigation revealed that the outcomes of UCL reconstruction are influenced by the surgical technique, the surgical facility, and the severity of the UCL injury. These findings help practitioners to evaluate symmetry and aesthetics.
