Open approach via the nasal dorsum with dermal graft for bifid nose

Bifid nose is a rare congenital anomaly and is also called double or cleft nose. The mode of appearance varies: from a simple groove at the nasal apex to a maxillary cleft. Neither surgical procedures nor the best time of surgery has been established. In this study, we performed dermal graft using an open approach via the nasal dorsum in patients with bifid nose and obtained good results. In the operation, a surplus skin of the nasal dorsum was resected through the nasal dorsum as a spindle graft and stored. The resected skin was denuded and the dermal graft applied on the nasal apex. For external nose plasty, it remains controversial which of 2 procedures, open or closed approach, should be selected. We have used the open approach to obtain a good surgical field. Nasal cartilage displacement could be confirmed under direct vision, facilitating cartilage correction. Furthermore, we could use the surplus skin component that is routinely abandoned and achieve a favorable nasal apex shape without adding supplemental invasiveness.