Asymmetric incision for open rhinoplasty in cleft lip nasal deformity

One of the problems in the correction of the unilateral cleft lip nasal def ormity is the alar web deformity on the mediosuperior side of the nostril. A number of methods for the correction of the alar web deformity have been introduced, but no single procedure has been identified as the standard. In this report, the incision line of the open rhinoplasty was modified and th e alar web deformity was corrected by using an incision and closure. Open r hinoplasty with the asymmetric incision was performed on 18 patients with u nilateral cleft lip nasal deformity. The incision line used in the normal s ide was the usual intranasal rim incision line and that used for the colume lla was the transcolumella incision line. For the cleft side, an intranasal rim incision line was plotted after the rim was lifted upward with forceps to achieve symmetry of the nasal tip. After removal of the forceps, the in cision line of the cleft side was displaced outside the nostril. After such an incision, the alar cartilage mobilization and suspension were performed with or without the conchal cartilage graft. All patients used nasal retai ners for 6 months after the procedures. So far, satisfactory results have b een obtained with the modification of the incision line for open rhinoplast y. This method is unique in designing the incision line, and its procedure is rather simple. The postoperative follow-up period has been 12 to 26 mont hs. A long-term follow-up is still needed, especially in growing children.