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Dean Toriumi, M.D.


Does Dr. Toriumi operate on patients with a cleft lip nasal deformity?

Yes. Dr. Toriumi has a very good experience treating patients with cleft lip nasal deformity.

Patients who have a cleft lip frequently have an associated nasal deformity. These deformities can vary in their severity. This deformity can leave the patient with severe asymmetries of the nostrils and base of the nose. Most cleft lip patients undergo initial nasal surgery as an infant to help improve the nasal shape and function at the time of the correction of the lip and palate defects. I do not do this early stage of the correction. Instead, patients with cleft lip nasal deformities come to see me once they are in their teens or as adults seeking improvement in their appearance and nasal function. I have used advanced techniques incorporating rib cartilage grafting to treat patients with cleft lip nasal deformities.

The combination of the rib grafting and specialized ear cartilage grafting allows me tremendous control for correcting deformities associated with the cleft lip nasal deformity. I consider the nasal deformities in these patients to be similar to a severe secondary rhinoplasty deformity involving the nostrils and nasal base. I find this type of surgery very satisfying, as the patients are very grateful for their correction and understand that perfection is not possible.


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The patient shown below had several previous surgeries to correct her nose, leaving her with a residual asymmetry of her nostrils and nasal base. I used rib cartilage and ear cartilage composite grafts to improve her nasal appearance. She is very happy with her outcome despite some residual asymmetry of her nostrils.










The next patient underwent several previous surgeries to correct her nasal deformity leaving her with near complete blockage or stenosis of her right nostril. This was a very complex deformity, and her inability to breathe through her nose made simple activities very difficult. We performed a multiple stage operation to correct her deformity using rib cartilage and a large composite ear cartilage graft. In the first stage, I placed the basic structure for her nose and corrected her nostrils to open her airway. In a second procedure, I refined her nasal tip. She is now over a year out from surgery and has a nice improvement in her nasal appearance and more importantly she can breathe through her nose.











Correcting severe nasal deformities in these patients is reconstructive surgery and can help patients in many ways including improving their self-esteem. I find these cases challenging and very rewarding.


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