ABSTRACT
Secondary rhinoplasty in bilateral clefts is very complex due to its specific pathological
anatomical characteristics. In this article, the general and specific characteristics
of the nose of the bilateral clefts are described and careful preoperative assessment
is emphasized. We discuss the timing of the operation considering growth inhibition
and psychological aspects and a systematic rational surgical approach, dividing the
operative procedure into: septal surgery, tip surgery, osseocartilaginous vault surgery,
maxillary augmentation, and alar base reallocation. We report results of a retrospective
study to evaluate the postoperative care with a custom-made vestibulum device to prevent
stenosis of the vestibulum caused by scar tissue retraction in the postoperative period.
KEYWORDS
Rhinoplasty - cleft lip - bilateral cleft - short columella - vestibulum device