Secondary correction of bilateral cleft lip nose deformity - Clinical and three-dimensional observations on pre- and postoperative outcome.

PURPOSE: The purpose of this study was to describe the clinical and three-dimensional (3D) outcomes following secondary correction of bilateral cleft lip and nose by reverse-U incision, nasal tip cartilage graft, and medial-upward advancement of bilateral nasolabial components with vestibular expansion with a free mucosal graft.

PATIENTS AND METHODS: Secondary correction of the bilateral cleft lip and nose deformity was performed on 11 patients with complete bilateral cleft lip, alveolus and palate (BCLP). In four patients with an extremely short columella, an inferiorly based small pedicle flap from rim skin rotating into the columella base was included to elongate the columella length. Pre- and postoperative nasal forms were recorded using photos and 3D data taken serially.

RESULTS: The nasal forms and lateral profiles were improved in all patients postoperatively. The pre- and postoperative 3D colour images demonstrated satisfactorily elongated columella length, symmetrically increased nasal tip projection, and enlarged alar groove. No serious complications were observed postoperatively.

CONCLUSIONS: Our secondary correction technique of the bilateral cleft lip and nose will provide successful results producing an adequate nasal tip projection and alar forms without damaging the upper lip tissue in patients with BCLP.