Cleft Lip and Reconstructive Surgery

Patients who have a cleft lip frequently have an associated nasal deformity. These deformities can vary in their severity. This deformity can leave the patient with severe asymmetries of the nostrils and base of the nose. Most cleft lip patients undergo initial nasal surgery as an infant to help improve the nasal shape and function at the time of the correction of the lip and palate defects. Dean did not do this early stage of the correction. Instead, patients with cleft lip nasal deformities come to see me once they are in their teens or as adults seeking improvement in their appearance and nasal function. Dean Toriumi had used advanced techniques incorporating rib cartilage grafting to treat patients with cleft lip nasal deformities.

The combination of the rib grafting and specialized ear cartilage grafting allows me tremendous control for correcting deformities associated with the cleft lip nasal deformity. Dean Toriumi considers the nasal deformities in these patients to be similar to a severe secondary rhinoplasty deformity involving the nostrils and nasal base. He finds this type of surgery very satisfying, as the patients are very grateful for their correction and understand that perfection is not possible.

The patient shown below had several previous surgeries to correct her nose, leaving her with a residual asymmetry of her nostrils and nasal base. Dean used rib cartilage and ear cartilage composite grafts to improve her nasal appearance. She is very happy with her outcome despite some residual asymmetry of her nostrils.