An approach to primary and secondary repair for the cleft lip nasal deformity is presented in a brief form. The approach borrows from a large number of sources, hence the use of the term “pastiche.” The sources include Millard, McComb, Anderl, Mulliken, and Cutting; Gunther, Rohrich, and Tebbetts; and Burget and Menick. A single case from each of the following cleft categories is presented and discussed: primary complete unilateral cleft, primary incomplete asymmetric bilateral cleft, primary complete bilateral cleft, and a secondary bilateral cleft. A description of the treatment method, its rationale, and a discussion are given for each category. There are a great number of varieties of the cleft lip malformation, but the principles presented can be applied to all of them.