Our Summary

This research paper discusses the complexities of performing nose reshaping surgery (rhinoplasty) on patients with a particular nasal deformity known as a cleft. The main challenge with this type of surgery is how to correctly reposition the base of the nostrils. The authors review different surgical methods and techniques used to address this issue. The success of the surgery depends on several factors, including the patient’s individual characteristics, their anatomy, the specific surgical technique used, and the surgeon’s level of experience. The paper further explores the available evidence supporting certain techniques and the authors’ preferred methods.

FAQs

  1. What are the challenges that a surgeon faces when performing a rhinoplasty on a patient with a cleft nasal deformity?
  2. What factors influence the outcome of a cleft rhinoplasty?
  3. What are the various surgical approaches and techniques for properly repositioning the alar base in cleft patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about rhinoplasty is to follow post-operative care instructions closely to ensure proper healing and optimal results. This may include avoiding certain activities, taking prescribed medications, and attending follow-up appointments as scheduled. It is important to communicate any concerns or questions with your surgeon during the recovery process.

Suitable For

Patients who are typically recommended for rhinoplasty include those who have:

  • Nasal deformities resulting from trauma or injury
  • Nasal deformities resulting from congenital conditions such as cleft lip and palate
  • Breathing difficulties due to a deviated septum or other structural issues in the nose
  • Desire for cosmetic improvement in the appearance of the nose

In the case of cleft lip and palate patients, rhinoplasty is often recommended to improve the overall appearance of the nose and correct any functional issues that may be present. Cleft nasal deformities present unique challenges for rhinoplasty surgeons, and specialized techniques are often used to address these specific concerns.

Timeline

Before Rhinoplasty:

  1. Consultation: The patient meets with a plastic surgeon to discuss their goals and expectations for the surgery.
  2. Pre-operative evaluation: The surgeon assesses the patient’s nasal structure, skin thickness, and overall health to determine the best approach for the procedure.
  3. Pre-operative instructions: The patient receives instructions on how to prepare for the surgery, including any medications to avoid, fasting guidelines, and post-operative care.

After Rhinoplasty:

  1. Immediate post-operative period: The patient wakes up from anesthesia with bandages and possibly a splint on their nose to support the new shape.
  2. Recovery period: The patient may experience swelling, bruising, and discomfort in the days following surgery. Pain medication and ice packs may be recommended to manage these symptoms.
  3. Follow-up appointments: The patient will have several follow-up appointments with the surgeon to monitor healing progress, remove any sutures or packing, and make any necessary adjustments to the nasal shape.
  4. Long-term results: It may take several months for the final results of the rhinoplasty to be fully visible, as swelling gradually subsides and the nose settles into its new shape. Regular check-ups with the surgeon will ensure that the patient is happy with the outcome and that any concerns are addressed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rhinoplasty for a cleft nasal deformity may include:

  1. What experience do you have in performing rhinoplasty on patients with a cleft nasal deformity?
  2. What specific techniques do you recommend for repositioning the alar base in cleft rhinoplasty?
  3. What are the potential risks and complications associated with rhinoplasty for cleft patients?
  4. How long is the recovery process and what can I expect in terms of post-operative care?
  5. Can you provide before and after photos of previous cleft rhinoplasty patients you have treated?
  6. What are realistic expectations for the outcome of the surgery in terms of both function and appearance?
  7. How many follow-up appointments will be necessary after the surgery?
  8. What is the cost of the procedure and do you accept insurance for cleft rhinoplasty?
  9. Are there any alternative treatment options for addressing my cleft nasal deformity?
  10. Can you provide references or testimonials from previous cleft rhinoplasty patients?

Reference

Authors: DeVictor SR, Tollefson TT. Journal: Facial Plast Surg. 2023 Dec;39(6):668-673. doi: 10.1055/a-2127-3665. Epub 2023 Jul 11. PMID: 37433309