Abstract
AbstractThe secondary cleft nasal deformity presents a challenge for the surgeon devoted to deliver high-level longitudinal cleft care. The underlying complex anatomic deformities combined with scarring from a needed primary rhinoplasty make the secondary cleft rhinoplasty a challenging procedure, with no consensus about a single surgical approach to fully address the multilayered abnormality (skin, cartilage, vestibular lining, and skeletal base platform). This chapter addresses the surgical approach to the secondary cleft nasal deformity after skeletal maturity, highlighting the abnormalities of unilateral and bilateral cleft nasal deformities and its surgical treatment aiming nasal symmetry from the top-down with definition and straightening of the nasal dorsum, adjustment of the nasal tip (rotation, projection, definition, and length), proper alar base repositioning, and improvement of nasal airway functioning. Multiple surgical techniques, that is, component nasal dorsum reduction, nasal dorsum argumentation, septoplasty, spreader flaps, spreader grafts, columellar strut graft, septal extension graft, cephalic trim, nasal tip suturing methods, tip grafts, alar base mobilization, nasal osteotomy, and inferior turbinate reduction, are also reviewed.KeywordsCleft nasal deformitySecondary cleft rhinoplastyCleft
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