Why cleft lip and palate revision rhinoplasty is challenging and methods for rib cartilage reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who underwent revision rhinoplasty to achieve a more defined nasal line after cleft lip and palate correction.

• Childhood: Cleft lip and palate surgery (during middle school)

• 10 years ago: Alar reduction + silicone implant surgery

• 4 years ago: Donor rib cartilage + silicone implant surgery at NOSELAB

1. Special notes

• Underlying nasal structural deformity caused by cleft lip and palate

• Satisfied with the previous natural result, but now desired a more dramatic, defined change

• Rhinitis symptoms present

2. Desired areas of improvement

• Flared nasal shape

• Position of the nasal tip

• Overall three-dimensional definition

• Nasal tip elevation

• Improvement of a wide nose

• A more defined and prominent nasal line than before

• Initially desired a natural look, but now wanted a more pronounced change

1. Structural reinforcement

• Septal reconstruction using autologous rib cartilage

• Replacement of existing graft with autologous rib cartilage

• Creation of a stable structural support

2. Shape improvement

• Elevation of the nasal tip

• Correction of wide nose

• Creation of a more defined nasal profile

3. Detailed adjustments

• Nasal sill reduction

• Functional surgery to improve rhinitis

• Securing overall balance

1. Front view

• Slimmer nasal line

• Three-dimensional nasal tip

• Improved nasal tip symmetry

2. Profile view

• More defined nasal line

• Elevated nasal tip

• Harmonious overall proportions

3. Nostrils

• Reduced nasal sill

• Anticipated improvement in rhinitis symptoms

• Balanced overall structure

This case is unique in that the patient, who had undergone cleft nasal reconstruction at our clinic 4 years ago and was satisfied with a natural outcome, returned seeking a more defined and prominent change. Because structural stability is far more critical in revision rhinoplasty for cleft lip and palate patients than in conventional revision cases, we established a firm foundation through septal reconstruction using autologous rib cartilage.

In particular, we focused on elevating the nasal tip and correcting the wide nasal structure, while concurrently performing nasal sill reduction to achieve the refined, defined nasal line the patient desired. This allowed us to advance a step further from the previous natural result.

This was Dr. Peter C. Kang. Thank you.

Thank you.

#closedrhinoplasty #revisionrhinoplasty #cleftlipandpalate #autologousribcartilage #customrhinoplasty