Repair of a bilateral cleft lip deformity is challenging yet rewarding. Many surgeons find it hard to achieve results comparable to those of unilateral repairs. Poorly planned surgeries can leave noticeable residual deformities. There is a combination of genetic and environmental factors that may affect development of cleft lip in weeks 4 to 10 of gestation. Bilateral cleft lip and palate is recognized by the presence of a central echodense mass in the region of the upper lip. This mass is known as the premaxillary protrusion and it represents abnormal alveolar and gingival tissue due to uninhibited growth of the premaxilla caused by lack of continuity of the bony, gingival and lip structures. This case report is going to throw light on the unique surgical technique for severly prominent premaxilla in bilateral cleft lip and palate using reductive ostectomy on the vomero-premaxillary suture.