Primary Cleft-Lip Rhinoplasty Using the Vestibular Z-Plasty Technique

Objective: Most of the studies support that primary rhinoplasty during cleft-lip repair results in good outcomes with no effects on nasal growth. This study, through the analysis of patients with congenital unilateral cleft lip, explores the efficacy of the vestibular Z-plasty technique for primary nasal deformity repair. Methods: Since 2023, a single surgeon has operated on 12 consecutive unilateral cleft lip and palate patients with associated nasal deformities. The method involves nasal vestibule lengthening using a lateral Z plasty to reshape the nostril, improving symmetry. The outcomes were evaluated through anthropometric measurements of the repaired nose during at least 1 year of follow-up. Results: Total nostril symmetry has been achieved in 9/12 (75%) of cases for 1 year or more of follow-up. A major revision requirement (more than 3 mm of asymmetry in any of the studied parameters) was observed in 8.3% of cases. Conclusions: Proposed vestibular Z plasty cleft rhinoplasty is a good approach to improve the nostril appearance in patients with unilateral cleft-lip nasal deformities. Longer follow-up time and comparative studies are needed to evaluate its efficacy.