Secondary cleft rhinoplasty: Combining an open rhinoplasty with the dibbell technique and tajima incision

Abstract

The definitive correction of secondary nasal deformities after cleft lip repair remains one of the formidable challenges of the rhinoplasty surgeon. The lower third of the nose, in particular, can contain many residual malformations including a lateralized alar base, shortened columella, depressed lower lateral cartilage, and nostril apex overhang. The authors describe an open rhinoplasty that is combined with a Dibbell technique and Tajima inverted-U incision which we have successfully used to correct persisting cleft nasal deformities affecting the lower third of the nose. This combined technique has the advantages of wide exposure of the tip cartilages, anatomic repositioning of the depressed lower lateral cartilage, correction of the lateralized alar base, and recontouring of the nasal tip skin envelope.