Before & After Gallery
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Before and After Gallery - Cleft patients


Patient 1.   Anatomy, previous history:   9 years old male patient with congenital, bilateral cleft lip and palate, our preop photos show the bad results and condition due to the correction attempts with inappropriate methods and also missed interventions of another plastic surgery clinic (the first group of 6 photos). On the photos 1-2-3. you can see the vertical scars - instead of making them zigzag - contracting the upper lip upwards, also the cavernous nostril bases without prior narrowing attempt. The photo 4. shows that during the former lip correction it also wasn't attempted to reconstruct the perioral muscle ring (oral sphincter) in the middle, when making a purse the muscle stumps bulge on the sides. The photos 3., 5. and 6. show the complete failure of orthodontics and also that the bone grafting to close the alveolar cleft (the aperture above the 2. incisors) was absolutely missed.
     
Postop photos after our procedures (the second group of 6 photos): the photos 1-2-3. show the corrected upper lip and the vermilion border, the reconstructed oral sphincter, the reduction and conversion of the vertical scars to zigzag lines. The inside of the nostril bases was made more narrow, and the columella (the fleshy external end of the nasal septum) longer with a composite skin-cartilage graft harvested from the ear, the latter also to prevent the downward contracture of the nasal tip in the course of growing up. These photos were made only a few weeks after the operation. The photo 4. shows the good function of the reconstructed oral sphincter when making a purse. The photo 5. shows the early result of the effective orthodontic treatment after closing the alveolar cleft with spongious bone graft harvested from the hip-bone. The photo 6. shows well the shape of the upper lip and the scars 1 year after our operations.
Later on we plan the reconstruction of the nasal wings and the nasal tip, the definitive, final correction of the nose is recommended after the age of 18.





Patient 2.   Anatomy, previous history:   32 years old male patient with a congenital left sided cleft lip and palate, in his childhood he underwent several operations with numerous complications, giving very modest results. On the preop photos in the top row, the photos 1. and 2. show the significantly deviating nasal axis (with a septal deviation disturbing the breathing) and the asymmetric nasal tip and nasal wings. The nostril base remained wide on the left side, underneath the unclosed alveolar cleft can be clearly suspected (missed or failed operation), and a scar is pulling the upper lip upwards. The photo 3. shows the bony hump of the nasal bridge (dorsum), the pulled-up upper lip and the nasal tip turning somewhat downwards. The photo 4. shows the cavernous opening of the hard palate, through this liquids can freely pass into the nose at meals and drinking.
       
       
On the postop photos in the bottom row, the photos 1-2-3. show the result of our lip and nose correction, that we performed 4 months after the closure of the alveolar cleft with spongious bone graft harvested from the hip-bone (operated by Dr. András Huszák, specialist for maxillofacial surgery). With cartilage grafts harvested from the ears, we performed an open rhinoplasty and built up the nasal wing and made the nasal tip more symmetric, simultaneously we corrected the deviation of the bony-cartilaginous septum and the nasal axis, the scar of the upper lip and also the nasal base. The photo 4. shows the result after the closure of the cleft palate, in this operation Dr. Ferenc Oberna (specialist for maxillofacial surgery and microsurgery) transplanted a free flap from the underarm into the defect surrounded by severe scar tissues.






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