Sculpting Symmetry: Evaluation of a Refined Combined Surgical Technique for Cleft Nose Deformity Correction Publisher



Amirizad E ; Amirizad J ; Firouzifar M ; Saeedi N ; Heidari F
Source: Journal of Maxillofacial and Oral Surgery Published:2026

Abstract

Objective: Cleft rhinoplasty remains a challenging procedure due to multi-level asymmetries, tissue deficiencies, and long-term secondary contractile forces from scar formation that may lead to recurrence of deformity. Various surgical techniques have been described with differing approaches to correction. This study aimed to quantitatively evaluate outcomes in patients undergoing cleft rhinoplasty using a combination of Dibbell’s and Tajima’s techniques within an open structural rhinoplasty approach, along with additional refinement techniques. Methods: This study included 34 primary patients with unilateral cleft nasal deformity (mean age: 26.6 years) who underwent rhinoplasty using the described combined approach. Basal view photographs were analyzed to assess nasal sill asymmetry, nostril angle, nostril height asymmetry, and tip deviation. Measurements were obtained and analyzed as paired proportional values. Results: Postoperative analysis demonstrated a significant increase in the nostril axis angle toward a more normal position by approximately 11 degrees. Sill asymmetry and nostril height asymmetry were reduced by 11.46% and 7.1%, respectively. Tip deviation improved from 16.25 degrees preoperatively to 5.6 degrees postoperatively. All changes were statistically significant (p = 0.001). Conclusions: The combination of Dibbell’s and Tajima’s techniques within an open structural rhinoplasty framework, supplemented by refinement techniques, is effective in correcting cleft nasal deformities and asymmetry with sustained improvement over a reasonable follow-up period. © The Association of Oral and Maxillofacial Surgeons of India 2026.