Rhinoplasty or Septoplasty in a patient with a history of a cleft lip repair can be more tricky due to inherent asymmetry in the nasal tip cartilages and the septal cartilage. The nasal tip cartilage on the cleft side is typically depressed and leaning to this side. The nostril is typically more collapsed on the cleft side and the septum is typically deviated to the cleft side.
It is important to support this tip cartilage on the cleft side with strut grafts made from cartilage and suturing techniques. It is also important to center the cartilaginous septum which is typically tilted onto the cleft side obstructing the nasal airway on this side and leading to an asymmetric nostril.
Rhinoplasty can be difficult due to the lack of cartilage for grafting purposes. At times, ear cartilage may be necessary to reconstruct the nose.
Dr. Funk is a facial plastic surgeon and rhinoplasty specialist in Houston, TX.