Effective management of cleft lip requires a comprehensive interdisciplinary approach that addresses the multifaceted dimensions of care. Although treatment spans infancy to adulthood and outcomes are influenced by growth and development, the critical stage of care is at primary reconstruction. This review aims to integrate recent insights from data-driven 3D analysis of cleft lip and nasal deformities into our foundational approaches for primary reconstruction of both unilateral and bilateral cleft lip. It also aims to organize the many methods of repair of both lip and nose according to principles of surgery so that, similarities, differences, and controversies can be highlighted.