Cleft-Related Nasal Asymmetry Correction Using Autologous Cartilage – A Complex Reconstruction Story

noselab
10월 2일
2분 분량

Cleft-Related Nasal Asymmetry Correction Using Autologous Cartilage – A Complex Reconstruction Story

Hello, I’m Dr. Cha-Young Kang, Director of NoseLab Clinic.

Today, I present a challenging yet inspiring case of cleft-related nasal asymmetry correction in a patient born with bilateral cleft lip and palate. Through careful use of autologous rib and ear cartilage, we restored structural stability, improved symmetry, and created a natural nasal balance.

Patient Background and Surgical History in Cleft-Related Nasal Asymmetry

Preoperative consultation photos for cleft-related nasal asymmetry correction – frontal, oblique, and side views of female patient — Preoperative design consultation photos: Frontal view, left oblique side view, and left side view.

Congenital and Surgical History:

Infant: Repair of bilateral cleft lip, palate, philtrum
Childhood: Alveolar bone graft, septal reconstruction
Adolescence: Lip and alar reconstruction with ear cartilage and lip flap
Adulthood: Orthognathic surgery, two rhinoplasties, further lip revisions

Preoperative consultation photos for cleft-related nasal asymmetry correction – right side, right oblique, and nostril views of female patient — Preoperative design consultation photos: Right side view, right oblique side view, and nostril view.

Health Factors:

Asthma requiring nebulizer
Mild hypertension (peaks with anxiety)
Allergic rhinitis with frequent nasal discharge

Surgical Challenges in Cleft-Related Nasal Asymmetry Correction

Altered anatomy from congenital deformity and prior surgeries
Thinned, scarred tissues limiting grafting options
Persistent nostril asymmetry due to cleft origin
Need to balance function, stability, and natural aesthetics

Stepwise Strategy with Autologous Rib and Ear Cartilage Reconstruction

1. Septal Reconstruction with Rib Cartilage

Harvested rib cartilage for a strong septal framework

2. Dorsal Enhancement

Corrected hump, created smooth, elevated dorsal contour

3. Alar Reconstruction with Ear Cartilage

Restored alar support and improved nostril symmetry

4. Lateral Osteotomy

Realigned nasal bones, reduced width, corrected asymmetry

5. Columella and Nostril Refinement

Adjusted nasolabial angle for elegant projection

6. Functional Support

Preserved airway and reduced rhinitis symptoms

Results – Functional and Aesthetic Improvements after Cleft-Related Nasal Asymmetry Correction

Structural: Durable rib framework ensured stability
Aesthetic: Balanced nostrils, narrower bridge, natural profile
Functional: Breathing preserved; reduced rhinitis symptoms

Before and immediately after cleft-related nasal asymmetry correction – frontal view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Frontal view: Improved nostril and alar symmetry

Before and immediately after cleft-related nasal asymmetry correction – side view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Profile view: Refined dorsal contour, elegant columella, reduced nostril exposure

Before and immediately after cleft-related nasal asymmetry correction – nostril/base view comparison of female patient — Before Surgery (Left) / Immediately After Surgery (Right)

Expert Reflections on Cleft Nasal Reconstruction

Cleft-related nasal asymmetry correction is among the most demanding rhinoplasty procedures.

Preoperative Video / Immediate Postoperative Video

Success requires:

Rib cartilage for long-term durability
Ear cartilage for delicate alar shaping
Precision osteotomy and columella adjustments
Careful anesthesia for asthma/hypertension patients

This case demonstrates that even after multiple prior surgeries, cleft-related nasal asymmetry correction is achievable with a structural, patient-centered approach.

— Dr. Cha-Young Kang, NoseLab Clinic