Correction of the cleft lip nasal deformity involves repositioning of the lower lateral cartilage on the cleft side to raise the dome, lengthening the columella and bringing it toward the midline, and correcting any asymmetries of the nasal floor. Additional structural support in the form of bone or cartilage grafts is often required in order to achieve the desired projection and angularity. Our experience with these grafts in a large number of patients over the past 20 years has shown them to produce good, predictable results that are long lasting, with minimum donor site morbidity. Long-term follow-up indicates that these grafts maintain their volume and original features, resulting in satisfaction among our patients.