Deformity of normal nasal architecture is commonly seen in individuals with cleft lips (see Fig. 27-2). If the cleft extends into the floor of the nose, the alar cartilage on that side is flared and the columella of the nose is ulled toward’the noncleft side. A lack of underlying bony support to the base of the “nose compounds the problem. Surgical correction of nasal deformities should usually be deferred until all clefts and associated problems have been corrected, because correction of the alveolar cleft defect and the maxillary skeletal retrusion wrll after the osseous foundation of the nose. Improved changes in the nasal form will therefore result from these osseous procedures.
Thus nasal revision may be the last corrective surgical procedure the cleft-afflicted individual will undergo.