The cleft lip is a very common condition and present in children from birth. This condition causes deformity in the lips and the nose. On appearance a cleft lip can be unilateral or bilateral. A cleft lip appears as if the upper lip is joined to the nose or the sides of the cheeks. The appearance of the cleft lip can be very depressing for children as well as adults.
Cleft lip Rhinoplasty is a complex Rhinoplasty procedure that attempts to correct the deformity of the lips and nose to restore the balance to the facial features. As both the upper lip and the nasal area are involved, only expert rhinoplasty surgeons can perform this correction. Traditionally, cleft lip surgery did not involve nose correction. However, over the years, it has been established through numerous studies that cleft lip Rhinoplasty is an excellent procedure to help the patient be comfortable as the combination helps the patient’s nose grow in a symmetrical fashion.
Cleft Lip Rhinoplasty Surgery
Cleft lip Rhinoplasty surgery is a complex Rhinoplasty because it involves the surgeon working with the skin, cartilage, mucosa and the skeletal platform underneath. The surgeon will do a careful evaluation of the child’s deformity and work out with the parents the best techniques and methods to use.
For the cleft lip surgery, the timing is everything. If too many changes are made too early in the nose and lip too early on it can lead to problems later on. Hence, cleft lip rhinoplasty is divided into three: primary rhinoplasty, intermediate rhinoplasty and secondary rhinoplasty. The first treatment that can be given at the age of one month includes a combination of non-surgical nasoalveolar molding and primary Rhinoplasty. Primary rhinoplasty includes both nose and lip to be worked on simultaneously and the two structures should be considered at one for repair and reconstruction. This way the surgeon can give better contour and symmetry to the organs.
Intermediate Rhinoplasty for cleft lip management can be done anywhere between the age of four to six. This rhinoplasty gives the surgeon the freedom to make any revisions and give better symmetry to the nasal tip. Also if there is any obstruction the air way it can be corrected at this stage. One of the prime concerns of cleft lip treatment the nasal asymmetries that might occur when the facial growth is complete. Care has to be taken that the septum is not interfered with so that the growth is proper. Therefore in intermediate Rhinoplasty, the irregular cleft side is corrected to stop cleft nasal deformity.
Secondary Rhinoplasty is performed when the patient’s facial growth is complete i.e. after the age of fourteen. At this age, the septum can be worked on, to straighten the nose. Generally, an open approach is used to ensure better exposure to correct the cleft nasal deformities. Cartilage grafts can be used at this stage to support and reinforce the structure for more permanent results.
Apart from correcting the cleft lip deformity cleft lip Rhinoplasty will also help in correcting the nasal tip, alar defects, and vestibule and dorsum corrections. Thus, covering the whole aspect of nasal deformity correction.
The goal of using a three stage Rhinoplasty with cleft lip correction is to ensure symmetry, alleviate growth deformities and ensure proper structural growth. Since it is a complicated procedure, therefore care should be taken at various stages of the patient’s life. Since cleft lip Rhinoplasty is performed on the children, extra care has to be taken after the surgery to ensure that recovery is full, without any further injury and trauma to the nose and lip.