Tessier number 7 cleft with unilateral complete cleft lip and palate: a case report

To date, there have been no reports of patients showing a Tessier number 7 cleft with unilateral complete cleft lip and palate. Furthermore, no studies have established the sequence, plan, or timing of surgical methods for treating patients presenting the above anomalies simultaneously. We report a case of a Tessier number 7 cleft with unilateral complete cleft lip and palate. Two months after birth, lip adhesion was performed on the unilateral complete cleft lip and total excision was performed on the skin tag. At 4 months of age, Tessier number 7 cleft was corrected. At 6 months of age, surgery involving two small triangular flaps was performed on the unilateral incomplete cleft lip after performing lip adhesion. At 13 months of age, two-flap palatoplasty with a vomer flap was performed on the complete cleft palate. At 6 years of age, open rhinoplasty was performed on the unilateral cleft lip nose deformity. At 9 years of age, bone grafting was performed for the alveolar cleft. At follow-up appointments up to 13 years of age, there were no major complications. Here, we present this patient, surgical procedures and timelines, and show our results demonstrating good postoperative outcomes.

Narrowing the Wide Tip via Endonasal Approach

Rhinoplasty is arguably the most complex and intricate surgery performed by facial plastic surgeons. Nasal tip refinement of a broad nasal tip has remained the most challenging part of rhinoplasty as sophisticated techniques are critical to achieve aesthetically pleasing and structurally sound nasal tips that can withstand the contractile forces of healing. Successful tip refinement relies on an in-depth preoperative and intraoperative understanding of the patient's nasal anatomy, well developed arsenal of techniques, the experience of the surgeon, and the aesthetic desires of the patient. Although the approach to gain access to the nasal tip so as to successfully reshape the tip has been a topic of debate over many years, the aim of this article is to outline and demonstrate how the broad nasal tip can be successfully recontoured through an endonasal approach using nondestructive techniques that have been effectively used in open rhinoplasty. We believe that there continues to be a place for endonasal tip rhinoplasty especially in this era in which patients desire less invasive procedures with shorter healing time.