This is a child with Bilateral Cleft Lip and Palate. Previously, the child was corrected for lip deformity. Now the current goal is to set right the palate and form the nasal floor. Usually owing to complexity of the procedure, it is often used by experienced surgeons for the wide palate and to create two separate nasal cavity. Vomerine flap recreates the nasal floor and is a type of palatal push back technique. Care has to be exercised to preserve the blood supply of premaxilla. During the procedure, care has to be exercised not to damage the tooth buds – which could give rise to several later problems. Rarely, a medial hamular osteotomy would be needed for push back to approximate the flap close enough. With a good vomerine flap, in the anterior region, there would be 2 separate nasal cavities which would latter fuse to form a single cavity in the posterior region.