Q: Dr. Eppley, my one month old son has cleft lip and palate on the left side. It is due to be repaired in another few months. Besides the cleft lip, the nose is also very distorted and wide set. Can his nose also be corrected at the same time as that of his cleft lip repair?
A: The initial cleft lip repair is usually done around the age of three or four months after birth. During a primary cleft lip repair, efforts are always made to reshape the distorted nostril and tip of the nose. Some of the nose improvements are natural as the lateral lip element is one and the same with the base of the nostril. So the base of the nostril naturally gets better as the two sides of the lips are brought together and united. But one should not think of this nose effort as a definitive rhinoplasyt or a complete correction. The lower alar cartilages of the nose are still deformed and remain small in development. They are far from completely formed and these initial nasal correction efforts at the time of the cleft lip repair are mainly to improve the width of the nostril base. The nose must undergo further development and additional nasal work will be needed during the early school and teenage years to more extensively reshape the deformed tip cartilages and correct septal deviations and other nasal abnormalities.
Dr. Barry Eppley