Management of the cleft nasal deformity has been a subject of debate since the advent of cleft lip repair. Historically, surgeons expressed hesitance to surgically intervene at an early age for fear of causing restriction of nasal growth; however, over the past 30 years, early and aggressive nasal intervention has become standard practice. As such, secondary cleft nasal deformity encountered today represents a complex combination of the inherent deformity and the effects of initial attempts at repair.
A number of operative techniques and variations on timing of surgery have been proposed thus far, attesting to the challenge this patient population continues to present to even the most experienced surgeons. The goals of the surgery are to address the dysmorphic deviated nostril on the cleft side and the vertically short columella as well as to restore nasal symmetry and projection.
Dr. Tahiri typically addresses the tip of the nose at the time of cleft lip repair. However, when patients presents with secondary nasal deformities, Dr. Tahiri performs a tip rhinoplasty in order to restore alar (nostril) symmetry and nasal tip projection along with colummellar lengthening.
Along with the psychosocial benefit of restoring normal aesthetics, operative repair may alleviate the nasal obstruction frequently associated with weakened cartilages (thus weakened nostrils) and subsequent external nasal valve collapse.