Facial plast Surg 2002; 18(3): 179-186
DOI: 10.1055/s-2002-33064
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Secondary Rhinoplasty in the Bilateral Cleft

Gilbert J. Nolst Trenité
  • Department of Otorhinolaryngology, Academic Medical Center of the University of Amsterdam, The Netherlands
Further Information

Publication History

Publication Date:
30 July 2002 (online)


Secondary rhinoplasty in bilateral clefts is very complex due to its specific pathological anatomical characteristics. In this article, the general and specific characteristics of the nose of the bilateral clefts are described and careful preoperative assessment is emphasized. We discuss the timing of the operation considering growth inhibition and psychological aspects and a systematic rational surgical approach, dividing the operative procedure into: septal surgery, tip surgery, osseocartilaginous vault surgery, maxillary augmentation, and alar base reallocation. We report results of a retrospective study to evaluate the postoperative care with a custom-made vestibulum device to prevent stenosis of the vestibulum caused by scar tissue retraction in the postoperative period.