Page 131

Bilateral Cleft Nose / Columella Lengthening

Columella lengthening (primary rhinoplasty) - The ULTIMATE Clinical pearls To achieve the ultimate result various aspects have to be considered. Ignoring one or more of these aspects will lead to suboptimal aesthetic and functional results in columella lengthening (a minimal anterior primary bilateral cleft rhinoplasty). 1. Keep nasal sill and columella dissection minimal. Avoid extensive dissection of nasal dome and intra-crural soft tissue, as both are potential nasal growth centres. Do NOT destroy them as they help to provide normal nasal growth. 2. Adequately mobilise the skin of the columella as well as the anterior nasal floor including the nasal sill, this helps to avoid a “pig nose� appearance. To achieve appropriate nasal dome projection, the superior and median part of the crura are sutured. 3. Use former bilateral cleft lip scar, medial to the nasal sill, to place Burrow`s triangles, to avoid new scar formation and eliminate cutaneous tissue bulging at the lateral upper lip area. To avoid an additional scar, do not place a Burrow`s triangle lateral to the nasal sill! 4. A Burrow`s triangle may be used as an approach to the medio-central philtrum dimple to enhance a natural appearance of the central lip dimple with its philtrum edges (= the lip scars). 5. The superior aesthetic aspect of the philtrum edges can be enhanced, using the cranial part of the Burrow`s triangles to rotate these edges medially towards the naso-labial area. 131

Profile for IAOMS

Cleft Ultimate Treatment  

Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...

Cleft Ultimate Treatment  

Book: Cleft Ultimate Treatment -- Oro-facial and Cranio-maxillo-facial Deformities (Second Edition) Authors: Dr. Kurt Butow and Dr. Roger Z...

Profile for iaoms