Cleft Lip and Palate Rhinoplasty Case in Korea

noselab
2024년 10월 18일
3분 분량

최종 수정일: 9월 29일

Hello, this is Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.

Today, I would like to introduce a cleft lip and palate rhinoplasty case in Korea. Patients with cleft lip and palate often present with congenital asymmetry, making correction complex. While perfect symmetry may not always be possible, meaningful improvements can be achieved through careful planning and structural reconstruction.

Pre-Surgery Consultation for Cleft Lip and Palate Rhinoplasty

This patient had undergone multiple previous surgeries, including cleft lip closure, bone grafting, lip asymmetry correction, and nasal reshaping with silicone and ear cartilage.

Pre-Surgery Design Consultation: Frontal, Left Oblique, and Left Profile Views

Key concerns included:

Pinched appearance on the right nasal tip
Depressed columella and crooked nasal tip
Nostril asymmetry with right nostril collapse
Nasolabial angle less than 95°
Deficiency in the right maxilla revealed by CT imaging

The patient requested: correction of nostril asymmetry, improvement of nasal tip projection, restoration of balance, and creation of a more harmonious nose.

Pre-Surgery Design Consultation: Right Oblique, Right Profile, and Nostril Views

Facial CT and 3D CT images showing maxillary defect and nasal cavity asymmetry in a cleft lip and palate rhinoplasty case. — 1.Facial CT Images (Original Images) , 2.Facial 3D CT Images (Original Images)

CT scan images with colored lines showing septal cartilage deviation (yellow), nasal floor height difference (red), and rib cartilage graft reconstruction (blue) in a cleft lip and palate rhinoplasty case.

The yellow line represents the septal cartilage, while the red line indicates the height of the nasal floor. The white area shows the bone. The left side of the image corresponds to the patient’s right side.
The blue area represents the autologous rib cartilage used for septal reconstruction and to fill the depressed nasal floor on the right side. The floor height became more even, and the septum was shifted to the right, creating a straighter alignment.

3D CT images of a cleft lip and palate rhinoplasty case, showing depressed right maxillary floor (left) and predicted reconstruction using autologous rib cartilage (right). — 1.Image showing the depressed right maxillary floor, 2.Predicted reconstruction using autologous rib cartilage to fill the defect.

Surgical Procedure in Cleft Lip and Palate Rhinoplasty

a) Septal Cartilage Reconstruction – Autologous rib cartilage was used to reconstruct the deviated septum, shifting it to the right and stabilizing the nasal structure.

b) Right Alar Cartilage Reconstruction – Rib cartilage was grafted to reconstruct the missing right alar cartilage and anchor it symmetrically.

c) Nostril Correction – A composite graft (cartilage-skin graft) was performed to reshape the shortened right alar base and improve nostril symmetry.

d) Reinforcement of Nostril Floor – Rib cartilage was used to support the depressed right nostril floor and fill the maxillary defect, significantly improving nasal base balance.

All procedures were performed using a closed rhinoplasty approach, leaving no external scars.

Before and After Results of Cleft Lip and Palate Rhinoplasty

Frontal View:

Nostril asymmetry significantly improved
Crooked nasal tip straightened
Bulbous tip refined

Side profile view before surgery (left) after surgery (right)

Profile View:

Nasal tip projection enhanced
Natural dorsal line created
Nasolabial angle corrected to ~95°

Oblique View:

More harmonious nasal bridge line achieved

Nostril View:

Collapsed right nostril restored
Columella straightened
Reinforced nostril floor improved overall symmetry

Final Evaluation

Cleft lip and palate rhinoplasty is one of the most challenging forms of nasal surgery due to inherent asymmetry and structural deficiencies. This case demonstrates how septal reconstruction, alar cartilage grafting, and nostril floor reinforcement with rib cartilage can achieve both aesthetic and functional improvement.

While complete symmetry is often limited by scar tissue and previous surgeries, significant enhancement in balance and projection is possible. At Nose Lab Clinic, we focus on structural reconstruction, not just soft tissue adjustment, to provide long-lasting and natural results.

This has been Dr. Cha-Young Kang, head surgeon at Nose Lab Clinic.

Thank you.