Facial Plast Surg 2018; 34(03): 290-297
DOI: 10.1055/s-0038-1653986
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cleft Rhinoplasty: Strategies for the Multiply Operated Nose

Tsung-yen Hsieh
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, UC Davis Medical Center, Sacramento, California
,
Raj Dedhia
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, UC Davis Medical Center, Sacramento, California
,
Travis T. Tollefson
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, UC Davis Medical Center, Sacramento, California
› Author Affiliations
Further Information

Publication History

Publication Date:
01 June 2018 (online)

Preview

Abstract

Rhinoplasty, as a surgical procedure to improve the appearance of the nose while preserving or improving function, is complicated and difficult to master. Revision cleft rhinoplasty offers another tier of challenge. The symmetry, proportions, and definition of the nose are affected by the native cleft deformity but also previous surgical scars, cartilage grafts, and skin excisions. Our preferred approach is to use structural cartilage grafting to establish septal and lower lateral cartilage resiliency. Internal lining deficiency is addressed with skin or lining transfer, while excess nasal tip thickness is contoured to improve definition. Of the utmost importance, the cleft nasal deformity cannot be considered in isolation, but rather a combined amalgamation of the lip muscle and scar, dentofacial occlusion, and skeletal maxillary deficiency.