Tessier facial cleft is among the rarest facial clefts detailed in literary works and there are numerous issues contending around its multidisciplinary repairing methods. The authors describe a case of a 14-year-old girl with a neglected facial cleft associated with ADAM complex syndrome. The patient underwent soft tissue reconstruction using a combination of the forehead flap, bilateral mustardee flap, and Abbe flap. The results concerning the functional improvement for the soft tissue reconstruction are categorized as good in our terms. Surgical outcome analysis through a long-term follow-up becomes important to achieve the best possible results and patient satisfaction.