Cleft lip nasal deformity.

The nasal deformity in the cleft lip patient is produced by the lower lateral cartilage being subluxed inferiorly and laterally, which falsely lengthens the nose on the cleft side. The columella is not short. It simply extends laterally to a dipped area in the rim of the nostril. The cleft lip nasal deformity is correctable at the time of primary lip repair by advancing the lower lateral cartilage superiorly and medially. The correction will last with the cartilage fixed to the upper lateral cartilage-septal junction, its normal position. A deficient repair will not improve. A good repair will last, will not interfere with growth of the nose, and will free the patient from years of unnecessary embarrassment . Correction of the cleft lip nasal deformity in the adult requires repositioning of the lower lateral cartilage similar to what can be and should be done in the infant.