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There are 3 ages when a cleft rhinoplasty may be performed:
- During cleft lip repair – 3 months old
- At school age – 5-8 years old
- At skeletal maturity – 15-18 years old
The technique differs at each age.
What is Cleft Rhinoplasty?
Cleft rhinoplasty is a surgical procedure that corrects an abnormal nasal appearance caused by a cleft lip and a cleft palate.
Patients who have a unilateral cleft lip nasal deformity can benefit from this type of rhinoplasty, since it helps improve nose/nose tip symmetry and breathing. For patients who have a bilateral cleft lip nasal deformity, the procedure reduces nose width and helps improve nose tip projection.
Cleft Rhinoplasty Objectives
- To improve breathing with reconstruction of cartilage support. Breathing improvement may be noticed as relief from sleep apnea.
- To straighten the nose and provide a more appealing and balanced nasal shape that is specific for you.
State-of-the-Art Techniques
- Initial Cleft Nose Repair: Repositioning the “slumped” cartilages with a closed technique at the time of lip repair.
- Secondary Cleft Rhinoplasty (at school age): Improvement in nose tip projection and nasal symmetry using an open technique.
- Final Cleft Septorhinoplasty: Correction of septal deviation and fine-tuning the previous nose repairs.
Ideal Candidate
The ideal candidates for cleft rhinoplasty are people who are generally healthy physically and mentally, do not smoke or are ready to give up smoking, and have set realistic expectations and goals for what can be accomplished following the procedure.
Plastic surgeons typically wait until the patient reaches 15 years of age to perform secondary cleft rhinoplasty. This is to limit the number of rhinoplasty procedures and achieve the best results.
If you have undergone nasal surgery recently, it is recommended that you wait a year from the time of that surgical procedure. This will give you enough time to allow the soft tissue and skin to unstiffen and recover fully from the procedure.
Your Consultation
For underage patients seeking initial cleft nose repair, Dr. Bradley requires the parent or guardian to provide details about their child’s medical history. Patients who want to undergo secondary cleft rhinoplasty must discuss any previous surgeries and vitamins or medications they take, along with complete medical history details.
Things that will be discussed during the consultation will include the patient’s goals and expectations, different options for nasal deformity corrections, surgery preparation, and possible complications that might arise during or after the surgery. Dr. Bradley will also provide guidelines on proper care following the procedure.
The Cleft Rhinoplasty Procedure
General anesthesia is typically used during the procedure. A local anesthetic is also employed to minimize discomfort following the rhinoplasty. A majority of patients get their first cleft lip improvement and nasal correction procedure during the initial cleft nose repair.
A secondary cleft rhinoplasty’s purpose is to improve the projection of the nasal tip and improve nasal symmetry by employing the open rhinoplasty method. Dr. Bradley performs these enhancements by clearing the lower lateral cartilages, tunneling them, and readjusting them. After this procedure, the nose grows into a more symmetrical shape.
For final cleft septorhinoplasty, this procedure makes use of the open rhinoplasty method. The skin is detached from the bone and cartilage. Dr. Bradley might use grafts for the procedure – some cases may require the use of many graft materials to restructure the nose.
The nose will be closed with stitches. Soft splints may be positioned within the nose temporarily to provide support to the septum. Exterior splints are also utilized to reduce swelling and retain skin shape.
Recovery and Healing
For younger patients who have undergone cleft nose repair, the parent or guardian will be provided with advice by Dr. Bradley to help with a comfortable recovery for their child. A prescription for antibiotics and pain medication will be handed to the parents for their child’s use.
Patients who underwent secondary cleft rhinoplasty and final cleft septorhinoplasty require complete rest for several days to accelerate the healing process. Patients will also be provided with antibiotics and pain medication after the rhinoplasty. Common side effects of the procedures include bruising, pain, and swelling—these conditions will dwindle after a few days.
Dr. Bradley will provide patients with instructions on correct surgical site care. For instance, patients must avoid rigorous physical activity for several days. Patients are also advised not to shower and to instead take baths.
Cleft Rhinoplasty Cost
The cost of a cleft rhinoplasty procedure will depend on several factors. Factors that may influence the overall price of the rhinoplasty include complexity and duration of the procedure, surgical fees, and the fee for the anesthesia used during the surgery.
FAQ
Does a secondary cleft rhinoplasty have to be performed?
No, this is an optional procedure in most situations. It is aimed at providing the best appearance at a time when school socialization is occurring.
Why does the septal surgery have to wait until teen-aged years?
The septum is a center for face growth and so should not be operated on until maturity. In addition, the deviation is not that apparent until teen-aged years.
Schedule a Consultation
To arrange a consultation regarding cleft rhinoplasty in New York, contact the office of Dr. James P Bradley and set up your appointment. Dr. Bradley will go over the details of the procedure, including cost, preparation, and the post-surgical recovery process.
