Introduction

Cleft palate rhinoplasty is one of Dr Dan Robinson’s favourite procedures to perform because it is so challenging and also so rewarding. The challenges in rhinoplasty are magnified in cleft palate rhinoplasty and Dr Dan Robinson has a meticulous approach to these procedures with the goal of improving breathing through your nose, and improving the appearance of the nose.

Regardless of who you choose to do your cleft palate rhinoplasty Dr Dan implores you to ask the surgeon how many rhinoplasties the surgeon performs per year. This is not the operation for the occasional surgeon. Some of the hardest cleft palate revisions Dr Dan has done have been performed by surgeons who are not high-volume rhinoplasty surgeons. As a minimum, the surgeon should be performing:

• Over 100 rhinoplasties per year.
• At least 10 revisions per year.
• Preferably performed a facial plastic fellowship.

Unilateral Cleft Palate Rhinoplasty

There are multiple factors that Dr Dan Robinson looks for when treating a unilateral cleft palate rhinoplasty including:

• Caudal dislocation of the septum to one side with an immediate deviation of the septum to the contralateral side.
• Overly long medial crus on one side with a poorly developed lateral crus on the same side.
• Lack of vestibular skin.
• Lack of projection.
• Collapse of the alar.
• Nasal valve collapse.

Bilateral Cleft Palate Rhinoplasty

The factors causing the problem in bilateral cleft rhinoplasty vary from a unilateral cleft. In broad terms they are as follows:

• Lack of projection.
• Widely spaced lower lateral cartilages causing a bifid / boxy tip.
• Dorsal hump or pseudo hump [The lack of projection makes the illusion of a hump].
• Lack of septal cartilage support.
• Excess alar.

Treatment of Cleft Rhinoplasty

Dr Dan Robinson approaches cleft rhinoplasty with an open schedule – never rushing the operation. This ensures that patients get the best outcome. Dr Dan has also performed multiple revisions on cleft palate patients who have earlier undergone surgery with another surgeon. Common findings in these cases include:

• Not addressing septal deviation.
• Ongoing nasal obstruction.
• Lack of lower lateral support.
• Lack of projection.
• Lack of addressing dorsal hump / pseudo hump.
• Previous alar base reduction on the non-cleft side – exacerbating the nasal obstruction.

Regardless of whether the operation is a primary or revision surgery, Dr Dan uses the following broad guide to facilitate improving the nasal airway and appearance in cleft patients:

• Rib graft – usually allograft [from bone bank]
• External approach.
• Explanation of septum.
• Osteotomies if appropriate.
• Extended spreaders.
• Caudal extension graft for projection.
• Lower lateral cartilage replacement.
• Articulated rim grafts.
• Addressing sill stenosis / tightness.
• Potential composite grafting – taken from concha cymba of ear to further address vestibular tightness.

If you have a cleft nose and are seeking a rhinoplasty surgeon who has performed over 1500 rhinoplasties, make an appointment with Dr Dan. Dr Dan will tailor the operation to fit your needs for your cleft palate rhinoplasty.

Gallery

You can view before and after patient photos of Cleft Palate in the Cleft Palate Rhinoplasty Gallery.

Related Information

Cleft Palate Rhinoplasty

To discuss fixing your cleft palate, please make an appointment with Dr Dan Robinson.