Orofacial cleft is an exciting field for research. Hundreds of daily cleft lip operations worldwide are targeting the quality of either parent's or Professional health care providers' satisfaction. Objective: This is a Case series study to assess both guardians' and surgeon's satisfaction regarding one of the developing modified Millard techniques known as (Mishra) flap Introduced by an Indian Plastic surgeon in 2015 Patients and Methods: 20 infants with complete unilateral cleft lip were enrolled in our study, primary cheiloplasty by Mishra technique, keeping the white roll continuity. The Guardian continuously contacted for evaluation of esthetic outcomes obtained within a time frame (1 month and 3 months postoperatively. On the other hand, a professional assessment was obtained with two separate Consultants at the same mentioned time frame. Results: there was a significant increase in guardians’ satisfaction regarding residual scar visibility and maturation at 3 months compared with 1 month postoperatively. And regarding the professional assessment of philtrum column length was quite symmetrical with the contralateral un-clefted side at 3 months compared with 1 month postoperatively. Conclusion: The WRV Flap modification is a reliable modification for unilateral cleft lip repair, with very reasonable esthetic outcomes especially such as scar maturation and philtrum column length symmetry