1 Federal University of Parana; Curitiba, Brazil; Section of Plastic Surgery; Yale University School of Medicine; New Haven, Conn. (da Silva Freitas) Section of Plastic Surgery; Yale University School of Medicine; New Haven, Conn. (Shin) Section of Plastic Surgery; Yale University School of Medicine; New Haven, Conn. (Persing) Craniofacial Division; Department of Plastic and Reconstructive Surgery; São Paulo University; São Paulo, Brazil (Alonso) Assistance Center for Cleft Lip and Palate; Paraná, Brazil (Busato).