Plastic surgery is mostly about innovation and improvisation .Some techniques sell,others do not.
As a fingerstyle guitar soloist, I like to study jazz fingerstyle scores of famous American jazz guitar players. Some of the pieces have a basic 2-5-1 pattern and the improviser usually takes off on different tangents from there, making beautiful licks in the process.
There is not too much one can add to Millard's superb techniques in the art of cleft lip surgery. Modifications have been made to his classic presentation over the years by many plastic surgeons like Noordhoff and others .But all innovations are based on the basic principles of Millard.
In cleft palate surgery,there are numerous claims and counter claims .The time tested two flap procedures with Langenbeck variants,muscle repositoning methods used by famous plastic surgeons in the past have not changed much.The basic principles remain the same,more or less. The desire to re invent the wheel goes on and on.Not many extraordinary answers to old questions but many new players in the process. Many years ago, I met a young man who was treated by a famous Frenchay plastic surgery consultant for his complete cleft lip and palate speech.The surgeon had done a tremendous job. The boy had perfect speech and looked really handsome without any tell tale scars. That was nearly 19 years ago. Not many of us can get such results,despite massive technological advances since that time. That was the beginning of my journey in cleft missions.
As I sit in my office reading an amazing 7 page score by a former GIT (Music Institute, CA) teacher on the improvised version of Glen Miller's famous hit,"In the Mood" I notice that the basic 4/4 rhythm pattern is still the same,the introduction riff cannot be replaced by any other arrangement because it is the core essence of this famous jazz piece. The standard jazz walking bass line progression accompanying the score cannot be changed because it is tailor made for the song. The basic intro riff includes a simple progression using Ab7-Db7-Eb7. In the earlier years, this song was played by the Shadows and other old timers using basic chord patterns with wonderful results.
The US improviser in this newer and "jazzier" version adds some sophisticated progressions with a "Tuxedo Junction" thrown in. So you have Ab13-Ab0-Bbmi7-Ebsus4 and so on. It sounds great to the listener but one cannot help notice that the improviser has to return to the original score to get the real punch effect. Without it,the magic is gone and the riffs remain anonymous licks from progressive jazz improvisations.
I wonder where we guys would be today without Glen Miller and Ralph Millard?
The new US national anthem ,"In the Mood" is being improvised in some remote shangrila today...but the basic principles will always remain the same... :-)