What Is The Best Procedure For Paranasal Augmentation In A Cleft Patient?

Q: Dr. Eppley,  I am a cleft patient who have undergone successful cleft and rhinoplasty surgeries in the past. I am currently in the middle of teeth straightening and is looking for the right doctor for a paranasal implant procedure. Thank you for taking the time to read this message.

A: As a cleft patient I assume you are referring to the classic paranasal deficiency on the cleft side due to an underlying alveolar-maxillary deficiency. Because of its cleft origin I would be cautious about considering an implant for its augmentation. It would be best to first get a 3D CT face scan to see what the underlying bone around the cleft site looks like. If there is is a good bone foundation, usually from a prior alveolar bone graft, then an implant may be appropriate. (And the scan may show that a custom implant design may be needed) If not then either a cadaveric or autologous bone graft would be the more appropriate choice.

Dr. Barry Eppley

World-Renowned Plastic Surgeon