A Uniform Open Rhinoplasty Approach in Improving Nasal Aesthetics and Function in South-Asian Unilateral Cleft Patients
Rhinoplasty is one of the most challenging procedures in plastic surgery, and the unilateral cleft nose provides a distinct set of issues. The combination of this with distinct South Asian features including weak osseocartilagenous framework and thick and sebaceous skin presents a formidable challenge. We outline our approach in performing the open structural rhinoplasty in this group of patients to achieve desired aesthetic and functional outcomes.
Methods/Technique:
Twenty consecutive patients were included in the study. All were done via an open rhinoplasty approach, and spreader, columella lengthening and lateral crura strut grafts used. Dorsal augmentation was performed with diced cartilage wrapped in deep temporal fascia. Nasal tip projection (via the Goode method) and nasal tip rotation (nasolabial angle) were measured pre- and at 6 months post-procedure. Dorsal aesthetic line symmetry was assessed pre- and post-operatively. Patients were assessed on nasal airway patency and asked to subjectively grade their satisfaction with the procedure.
Results/Complications:
On average, nasal tip projection improved from 0.51 to 0.58 and nasal tip rotation improved from 74.8o to 89.4o. 25% of patients had symmetrical dorsal aesthetic lines pre-operatively, while post-operative analysis showed 90% patients with symmetrical dorsal aesthetic lines. 95% of patients reported patent nasal passages and 90% of patients said they were very satisfied with their outcome.
Conclusion:
With a uniform open rhinoplasty approach, satisfactory aesthetic and functional results can be achieved in our subset of South-Asian unilateral cleft nose with their inherent unique challenges.