Table 4.

Cleft Nose Deformity and Surgical Management

Cleft Nose Deformity	Surgical Management
Poor tip projection and definition	Tip sutures, cephalic trim, tip graft, columellar strut
Widened nostril sill	Y-V advancement, trim the C-flap, or readvancement of Millard advancement flap
Alar malposition and flattening	Cartilage grafts, V-Y advancement, horizontal mattress sutures, +more
Uneven alar base	Alveolar bone grafting to provide underlying support
Shortened columella	Columellar fork flaps plus columellar strut
Widened bony dorsum	Osteotomy and infracture of nasal bones
Septal deviation	Septoplasty and realignment of L-strut
Functional nasal obstruction	Spreader grafts to open internal valve, inferior turbinectomy, septoplasty
Fibrofatty thickening of the tip-lobule complex	Judicious sharp thinning of tip