dr@drmohanthomas.com |
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CLEFT, LIP & NOSE DEFORMITY |
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Deformity of nose occurs in varying degrees along with cleft lips. Although the lip gets corrected early on in life, the nose deformity persists as a stigma and it causes mental trauma to the affected. Deformities of the lips may remain and are treated at the time of nose surgery. The correction of such deformities is challenging and the results are rewarding. Nose function as well as appearance gets major improvement by surgery. Restoration of near normal appearance should be the goal. The surgical options are many and the results depend on judicious selection of technique keeping in mind the nature of deformity. Results are permanent. COMPONENTS OF CLEFT LIP NOSE DEFORMITYThe striking features of a cleft lip nose deformity are: - - The deviation of nasal tip. - Flattening and buckling of the outer wall of nostril. - Widening of the nostril on the affected side. These are a few other deformities which go along with these like deviation of the septum, bulbous tip, excess skin inside the nostril, a leak into the mouth and low nasal bridge. The severity of the deformities varies between different individuals. TIMING OF NOSE CORRECTIONThe nose deformity should ideally be addressed at the time of cleft lip closure. This is primary nose correction and gives good results. If the nose was not corrected early in childhood, the best time would to do so would be after completion of facial growth i.e. 14 – 16 years. METHOD OF CORRECTIONThe surgical plan depends on the deformity and your expectations. The bony and cartilage framework can be altered to create an aesthetically appealing nose. Skin excess can be trimmed or readjusted. Implants may be used in selected cases to improve the profile. The scar on the lip can be improved upon at the same time. In some cases, the upper lip needs to be plumped up and is one in the same sitting permanently using the patients own tissue. RECOVERY TIMEThe nose may be packed with gel foam for two days. Tapes over the nose come off in 4-7 days. Swelling over the nose takes a while to go off. Most of it resolves in 2-3 weeks. Stitches: removed in 4-6 days. Back to work: 3-7 days.
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