To compare landmark vs surface-shape measurements in a sample of patients with cleft lips and palates following secondary alveolar bone grafting. The faces of 10 patients (4 males and 6 females) with an unilateral cleft lip and palate were captured using a 3D surface camera system before and 6 weeks after alveolar bone grafting. In each face, six coordinates were registered. The pre- and postoperative images were superimposed on areas that were not affected by the surgery. Using 3D modeling software landmarks, nasal symmetry, and surface-to-surface deviation, analysis was performed. All data were subjected to standard statistical analyses. Color map surface-to-surface comparison revealed a significant anteroposterior elevation in the nasal region of the cleft side after surgery. The ala, alar base, and paranasal areas are increased anteroposteriorly after secondary bone grafting. This surgery tends to diminish the asymmetry in nasal morphology typically seen in patients with unilateral cleft lip and palate. Overall, 3D surface-to-surface analysis allows for a better quantification of treatment changes.