Abstract
The repair of the secondary deformities of the nasal ala caused by the unilateral cleft-lip contains many problems. The method of cleft-lip nose plasty reported by the author is as follows
1. The alar cartilage should be freed from both surfaces and repositioned symmetrically. In most of the Japanese with short and round nostrils, however, the whole cartilage might be removed with good results.
By my experiences, the sag formation of nasal ala seemed to be caused by the shearing forces which effect on the carilage and the vestivular skin in opposite directions.
2. To repair the wide nostril floor, the skin is excised in a wedge form or by the modified Millard's method.
A gap between the new nostril floor and the underdeveloped maxilla must be packed with autogenious tissues such as septal cartilage, vomer or some other soft tissues.
3. To repair the lateralized alar attachment, the connective tissu e beneath the alar lateral crus should be sutured with the periostium at the piriformis margin.
4. Dorsal nasal hump, named by J. T. Farrior, must b e removed to get the normal inside curvature of vestivulum.
5. The deviation of the septum and the anterior nasal spin must carefully be corrected to normalize the deviated ponticulus and to heal nasal obstructions
