With the continuous advancement of plastic surgery technology, the repair of nasal deformities secondary to cleft lip surgery can no longer be satisfied with mere elevation of the nasal wings and nasal column and reduction of the nostrils; bilateral symmetry and shaping of local details have become the goals pursued by the majority of plastic surgeons. Cleft lip is a complex embryonic developmental malformation that often involves skin, muscle, mucosa, cartilage and bone, and is a comprehensive, three-dimensional level deformity. The main manifestations are lip and nasal abnormalities of different degrees of appearance: marked upper lip scar, uneven red lip, white lip embedded in red lip, disappearance of lip beads, whistle-like deformity, half upper lip drooping due to overgrowth of the affected upper lip; nasal collapse, nasal lateral foot drooping, enlarged nasal facial angle, wide nasal base, deviated nasal column, nasal vestibular crease, deviated nasal septum, etc. Among the nasal deformities secondary to cleft lip, nasal collapse and drooping deformity are the most visual and serious deformities. There are many previous surgical methods for the repair of nasal deformities. For example, Tajima designed an inverted U-shaped incision on the cleft side of the nose to solve the drooping deformity of the cleft side of the nose, Nakajima based on Tajima’s method, Z-plasty in the cleft side of the nasal vestibule to improve the problem of tight mucosal pulling on the vestibule caused by the original method.
Holt simply excised the soft tissue of the split lateral nasal margin to obtain bilateral symmetrical nasal margins, and Basta reported a V-Y advancement of the mucosal cartilage flap to improve the nasal collapse caused by cartilage ectasia. However, detailed shaping of the nasal shape is often overlooked, for example, reconstruction of the nasal sill (i.e., a sill-like structure at the lower edge of the nostril), reconstruction of the nostril in a teardrop shape instead of a round shape, and shaping of the shallow groove above the nasal wing. Since 2012, we have used asymmetrical butterfly incisions combined with nasal vestibular mucosal flaps for the repair of nasal deformities, and also combined with ear cartilage or rib cartilage, which is now widely used internationally, for the shaping of the nasal shape, with good clinical results.