For the successful correction of the cleft lip nose,
Strong structural support is essential.
To lift the lower side of the nostril up to the level of the normal side,
I use a vertical strut using the rib cartilage,
and the strut is divided to make a strong arch to pull up the lower side of the nostril.
When the lower side of the nostril is lifted up,
additional tip grafting will be necessary for the refinement of the tip shape and symmetry.
Another important point of the cleft lip nose corretion is,
to make the asymmetric nostril base symmetric as much as possible.
I use rib cartilage graft at the lower side of the nasal base,
or I inject some diced cartilages to the base of the nostril.
Other important steps of clief lip nose rhinoplasty will be,
Correction of septal deviation, resections and lip or philtral scar managements.