Answer:
Repair of nasal deformities in unilateral cleft lip patients may be done at the time of primary lip repair, in the preschool years (ages 4-6); during puberty (ages 10-12), or as an adult. It had previously been thought that surgery early in life would disturb nasal growth, however this is no longer felt to be true.
There is no standard corrective surgery technique for cleft lip nasal deformity. The goal, obviously, is to restore nasal symmetry, which may require that the alar cartilage be modified by repositioning, suspension, alteration in size of augmentation with grafts. The general approaches include: 1. external approach; 2. alar cartilage mobilization and suspension; 3. alar cartilage incision and repositioning; 4. graft augmentation. (See McCarthy for further details-p.2803)