Cleft lip and palate patients represent one of the most difficult groups of patients for septorhinoplasty. Prior surgery at younger ages resulting in severe scar tissue is a major obstacle in most cleft rhinoplasties along with substantial asymmetries especially in the unilateral cleft patient. Replacement of missing and asymmetric cartilages and even bone is a key component for rhinoplasty in the cleft patient. Use of very sturdy cartilage typically from rib is almost always required to adequately resist the fibrotic soft tissues in the noses. Plus, rib cartilage can be carved into ideal septal extension and batten grafts that are required.
Part of the book: Contemporary Rhinoplasty