A beautiful cleft lip repair does not stop with a natural, reconstructed lip—attention also needs to be directed to a natural nasal reconstruction.
Cleft nasal reconstruction is a critical component of every one of the reconstructions that we perform for patients with a cleft lip. Accordingly, nasal repairs are key components of our surgical protocols from the very beginning.
For children with complete cleft lips, the gap extends into the nose, contributing to nasal deformity. In addition, the nasal cartilages are abnormally shaped with aberrant attachments, and the septum will most likely be deviated or crooked. For complete cleft lips with nasal deformity, Dr. Chen performs nasal dissection in order to free the cartilage from aberrant attachments and improve the nasal deformity. A formal rhinoplasty is not done until the teen years when the face and nose are skeletally mature. Because of its abnormal anatomy, a cleft rhinoplasty is usually more challenging than an aesthetic rhinoplasty.
The cleft rhinoplasty is performed under general anesthesia. Post-operatively, a nasal splint may be placed to help reduce swelling and protect the nose. Packing material in the nostrils may be left in place for 2-3 days. Swelling may last for several months after a cleft rhinoplasty, and the final appearance of the nose may not be apparent until all the swelling subsides.