The correction of a cleft lip nasal deformity is challenging because of its complexity and even more difficult when secondary correction of the unilateral cleft lip nose deformity. For an aesthetic appearance of the nose, a well-balanced relationship between nasal protrusion, nostril shape and columellar length are very important and many operative methods have been described such as direct excision of the skin of the alar web, the Z-plasty technique, V-Y plasty technique and the reverse-U incision. In this case report we used the reverse-U incision to extend the nostril size and length and also to reposition the lower lateral alar cartilage of cleft side. And a V-Y plasty was used to correct columellar shortage and close nasal mucosal defect induced y lower lateral alar cartilage traction. In this way, we have achieved a well-balanced relationship between both nostrils. The reverse-U incision with V-Y plasty creates a better nostril contour than does an another method. In this case report, we present secondary unilateral cleft lip nasal deformity who was treated using reverse-U with V-Y plasty method.