Summary Common faults with the lip-switch flap are that it occasionally is made too wide, too long, or inserted off-centre. Unilateral insertion in post-operative bilateral lip clefts is rarely if ever indicated and in unilateral clefts requires extensive camouflaging. Thus it is suggested that the lip-switch flap be inserted in the centre of the tight post-operative unilateral cleft lip, ignoring the previous unilateral scar. Then if the flap is fashioned narrow and incorporates the midline groove often present in the lower lip, its midline position will simulate an ideal, slender, dimpled philtrum. The pedicle of these flaps can be quite diminutive. In fact, the smaller full-thickness composite lip wedges can be free-grafted using the same donor area and position of insertion as in the flap.