Open Rhinoplasty for Correction of the Secondary Nasal Deformity Due to the Marcks Triangular Flap Cleft Lip Repair

Abstract

The Marcks Z-plasty modification of the Tennison triangular flap cleft lip repair results in excellent preservation of the Cupid's bow, but in more severe clefts this technique is stigmatized by a characteristic V-shaped nasal rim deformity. This has proven extremely difficult to correct secondarily. An open rhinoplasty technique is advocated because superior exposure is essential to visualize deficient components, as well as the malformed lower lateral cartilage, which is a direct result of this lip repair. Nevertheless, typical results remain substandard in terms of achieving nasal symmetry as opposed to routine use of the Millard rotation-advancement repair, with or without primary nasal correction.