Surgical Correction of Cleft Lip and Nose Deformity Associated with Augmentation Rhinoplasty Using Silicone Implant

ABSTRACT

The correction of secondary cleft lip and nose deformity often presents an extremely difficult plastic surgical problem. The deformity is a complex, three dimensional alteration in nasal anatomy with defects in all tissue layers : skin, cartilage, vestibular lining and bone. The patient who has these kinds of deformities undergoes the aggravation of deformities, as the patient grows older. And the decreased length of maxilla is accompanied by the deficiency of posterior development. As a result, the depression of nose and midface is usually developed and especially the depression of nose is severely noted in an oriental. To correct this secondary cleft lip nose deformity in Oriental patients, alar cartilge mobilization and suspension techniques have been developed. But, these techniques have critical limitations in the suspension vector and power. Oriental people usually have thin alar cartilages and thick skin. So, the suspended, deformed alar cartilage may relapse and pull the normal alar cartilage to the deformed side. To overcome these limitations, we have carried out the augmentation rhinoplasty using a silicone implant with Tajima's inverted U incision and interdomal suturing at the same time, which is inexpensive and easily handled, to twelve patients of secondary cleft lip and nose deformity for recent 2 years. The results were considerably satisfactory, so we report this paper and then can ascertain the further aesthetic benefits, such as the postoperative augmentation of a nose, finer nasal tip and the symmetry of both nostrils.