Cleft lip and cleft palate are anatomic differences in the center of the face seen at birth. These clefts, or separations in the tissues of the lip and palate (roof of the mouth), result when the normal patterns of embryonic tissue fusion (joining) fail.
What Is Cleft Lip Nasal Deformity?
In people born with a cleft lip, the anatomy of the nose is often altered because it is located close to and is developmentally related to the lip and palate. Thus, there is a condition referred to as a cleft lip nasal deformity. Sometimes, it is referred to as a cleft nose, although technically, that term may be referring to a different condition depending on who is using it.
What Is Cleft Rhinoplasty?
The term cleft rhinoplasty refers to a special type of rhinoplasty (nose surgery) that aims to improve the appearance and function of noses that have been altered as part of the cleft lip and/or palate condition.
What Nasal Deformities Appear in a Cleft Lip Nose?
Cleft lip nasal anatomy is often quite different from the typical nasal anatomy. The septum is the wall that divides the inner nose into a left and right side. This is often very deviated to one side in patients with cleft lip nasal deformity. Turbinates are curled structures of thin bone and mucosa (the wet “skin” on the inside of the nose) that serve a filtering function. The inferior turbinate is often enlarged on the side away from which the septum is deviated.
A deviated septum and enlarged turbinate can block airflow and create turbulent airflow. This is experienced as difficulty breathing through the nose.
The external portion of the nose in someone with a cleft lip and palate is also altered. The entire nose is often shifted to one side. The nasal tip frequently lacks projection as if it did not grow far enough out from the face. Additionally, the tip often has an asymmetric shape and irregular contours. The nostrils are generally vastly different from one another in shape, size, and position.
How Is Cleft Rhinoplasty Done?
A cleft rhinoplasty focuses on both the inside and the outside of the nose. The aims are to improve breathing and improve appearance.
Almost all rhinoplasties involve moving cartilage from one location to another within the nose to strengthen the changes made under the skin for stable, long-term results. In most rhinoplasties, the cartilage comes from extra that can be found in the septum. However, for cleft rhinoplasty, more cartilage is needed, and the septum provides less usable cartilage. Thus, cartilage is frequently borrowed from the ribs and ears.
How Do I Choose the Best Cleft Rhinoplasty Surgeon?
Cleft rhinoplasty is considered one of the most challenging types of rhinoplasty. Dr. Weinfeld has considerable experience in rhinoplasty and focused experience in cleft rhinoplasty. After his residency training, he spent an additional six months studying rhinoplasty from one of the world’s leaders in rhinoplasty and rhinoplasty education. Dr. Weinfeld is also an active member and has held leadership positions in the exclusive Rhinoplasty Society. Another distinction held by Dr. Weinfeld is being a member of a multi-surgeon team associated with Dell Children’s Medical Center of Central Texas located in Austin Texas. That team focuses on children who have congenital differences of facial structures.
Dr. Weinfeld is dedicated to delivering life-changing results to his patients undergoing cleft rhinoplasty. His dedication to advancing the field of cleft rhinoplasty can be seen in his scientific work in the field. You can view his published research study below on a technique to improve results in the area of nostril shape and symmetry.
Cleft Palate Craniofac J. 2020 May;57(5):537-542
Pyriform Costal Cartilage Graft Improves Cleft-Side Alar Asymmetry in Secondary Cleft Rhinoplasty.
Moore MLG1, Nguyen TC2, Day KM1, Weinfeld AB3.
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