I was born with a bilateral cleft lip and it left me with a larger than average nose.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 17 December 2012

Question

I am eighteen years old and am considering rhinoplasty. I was born with a bilateral cleft lip and it left me with a larger than average (although mainly symmetrical) nose.

I feel that my nostrils are quite large and the overall width of my nose is large. Although it doesn't look noticeable from a side view, it does from a front view.

I would be interested in knowing more about what you could do for me and how successful you think the rhinoplasty could be.

Answer

In my experience, and certainly in my hands, a situation as you describe is best addressed using rib cartilage grafts for support of the columella, and frequently for a slight augmentation of the pre-maxilla. The nasal septum is not usually a good source of cartilage in the context of bilateral cleft lip and palate, and I do not believe that ear cartilage would be suitable.

It is possible to narrow the appearance of the nose from the front, and frequently for lowering the nostril rim, which decreases the visibility of the nostrils I also use cartilage grafts.

I would be happy to see you in consultation and evaluate on computer simulation what it is that you would like to achieve and discuss possible advantages and limitations of surgery.

Mr Lucian Ion FRCS(Plast)
129 Harley Street
London
W1G 6BA