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Cleft Lip/Nose Deformity

Q. What is a Cleft Lip?

Cleft Lip is a common birth defect involving a separation of the two sides of the lip. During fetal development, the cleft in the lip normally joins together, however, in a Cleft Lip, the upper lip has formed incompletely. The condition impairs nasal airflow and can impact the growth of the nose.

A Cleft Lip may involve a tiny notch in the upper lip or a split from the lip to the nose. It can be present on one or both sides of the lip. About 50 percent of children born with a Cleft Lip also have a Cleft Palate, which is a split or separation in the roof of the mouth.

Clefts may be caused by a gene from one or both parents, health issues early in pregnancy or an abnormality in genes or chromosomes. A Cleft Lip is frequently associated with conditions like Down Syndrome. Speech and language problems, feeding issues, and breathing problems are some complications associated with a cleft lip.

Q. Can a Cleft Lip be fixed?

Yes. Cleft Lip can be repaired during a plastic surgery procedure called cheiloplasty. The reconstructive surgery will restore function, normal appearance, and growth of the lip.

The procedure is highly individualized for the patient and can be performed as early as when a child is 10 weeks old. Many times, one surgical procedure is all that is needed to repair a child’s cleft lip, other times multiple surgeries throughout the child’s development will be needed.

When a child presents with both Cleft Lip and a Malformed Nose, our facial plastic surgeon, can repair the nose. He will perform rhinoplasty on children as young as 15, provided that they are done growing.

Q. Can symmetry be improved?

Yes. During the procedure, our facial plastic surgeon, may close the Cleft, form a cupid’s bow in the center of the upper lip, and ensure proper distance between the upper lip and nose. While children typically only need one surgery to correct the Cleft Lip, sometimes asymmetry still remains and the lip appears too short on one side. This may require an additional surgery to correct the asymmetry.

Q. How does a Cleft Lip impact facial symmetry?

A Cleft Lip impacts the nasal area and may additionally require nasal revisions in order to correct any facial asymmetry. Ideally, this is done when the child is between ages 3 and 5. Problems in facial symmetry are often noticeable because either part of the nose did not develop properly or the cartilage of the nose is displaced down on the side of the Cleft. Cleft Lip and nasal surgery will improve the appearance of the nose and the lip.

Q. What is recovery like?

It will take several weeks for swelling to subside and for the patient to heal. Discomfort can be managed with pain medication. During this time, it’s important to prevent sun exposure and diligently apply sunscreen. If the surgery is done in an infant, scars will be thick, raised, and red at first, but gradually soften and nearly disappear over a year.

Q. Can symmetry be improved with a nose?

Facial plastic surgeons can improve the symmetry of a nose. With Cleft cases, our doctor also takes into account the fact that the nostrils are at different levels and have different circumference sizes. He can make great improvements in aesthetic appearance but nostrils can never be made completely symmetric.

Q. What is the recovery time for rhinoplasty?

The recovery time for rhinoplasty completed on a Cleft case is similar the recovery time for traditional rhinoplasty – approximately one week. Our patients benefit from his surgical skill and the advanced 3D, high definition technology he uses while operating. His approach is more precise and patients do not experience the same level of bruising. They are in fine shape after one week. Most will be back at work or school with minimal swelling after just one week.

Each case is unique and often with Clefts, our facial plastic surgeon performs open rhinoplasty. This technique gives him more liberty to use grafts to generate a more natural looking, high functioning nose. Recovery with open rhinoplasty may require a bit more time.

  • Nose Deformity - Before and After - front view
    Nose Deformity - Before and After - side view

    24 year old female from Egypt with a congenital cleft lip/palate/nose deformity who underwent surgery in New York to reconstruct her nose and upper lip deformities. Patient is shown only 1 week after surgery. Patient underwent revision rhinoplasty with septal and auricular cartilage grafts to correct her nasal deformities and a direct upper lip advancement and augmentation. Note patient is still swollen and red since she is only one week postoperatively from surgery. She had to go back to her country at 10 days and will visit Dr Rizk in future for further photos and follow-up. Patient required multiple grafts to straighten the nose and septum and had extensive deprojection of her tip/supratip complex done as well. She also had a severe deviated nasal septum repaired with septoplasty which is also typical with this congenital deformity.

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