Born with cleft lip; what would you recommend? (Photos)
Doctor Answers 2
Lip and nose asymmetry
I can see that you have undergone surgery for the lip and a hint of a scar suggesting you may have already also undergone surgery to the nose. You have achieved an excellent outcome; I can however see some minor remaining differences. The scar on the lip has cross hatching and there is a degree of flatness to the philtral column ridge (the vertical bulge or toll from nostril to Cupid's bow peak) on the right; there is a tiny mismatch at the vermilion border between the red and the white of the lip (called the 'white roll') and the right nostril sits recessed back compared to the left. I think the appearance could be improved by placing a small graft of skin or fat under the lip to plump up the deficiency whilst revising the scar with buried sutures so as not to produce cross hatching. The link at the white roll at the red vermilion white skin border could also be adjusted. Finally it would be possible to place a graft of tissue behind the right nostril base to try to encourage the nostril on that side to come forwards and better match the position of the left side.
I hope that information is helpful.
It looks like you have been in good hands so far for your previous two surgeries. Even the best cleft surgeons plan for patients to undergo multiple procedures.In your case, you may be ready for what we call a "definitive rhinoplasty." When you have stopped growing (not needing bigger shoes or clothes) we can do a rhinoplasty to try and create better symmetry in the nose. At the same time, we can do a lip scar revision. We can even out that small notch in the edge of the lip from the scar and make the lip scar slightly less noticeable.Make sure you go to a surgeon who is experienced in craniofacial surgery and has experience with cleft noses. These surgeries are different from regular rhinoplasty and the surgeon needs to understand the nature of the problem and have performed cleft surgery before.Best of luck!