A Novel Classification of Nasal Sill Morphology Provides Strategies for Secondary Cleft Rhinoplasty

Inconsistent and suboptimal outcomes in secondary cleft lip deformity repairs stem from the absence of a standardized classification system for nasolabial deformities, causing surgeons to rely heavily on their experience to determine surgical strategies. Nasal sill morphology reflects the severity of nasolabial deformities and plays a crucial role in facial aesthetics. This study introduces a novel classification for secondary cleft nasolabial deformities based on nasal sill morphology from the base view and provides tailored surgical techniques for each type.

The study included 276 patients who underwent secondary cleft nasolabial correction at Peking University Third Hospital between August 2019 and July 2024. Patients were categorized according to the novel classification system and received surgeries tailored to their specific deformity type.

Among the 276 patients, 13 (4.71%) were categorized as type I, 25 (9.06%) as type II, 73 (26.45%) as type III, and 165 (59.78%) as type IV. All patients achieved improved nasal sill aesthetics and enhanced nasal symmetry.

This novel classification system, based on nasal sill morphology, accurately characterizes secondary nasolabial deformities and offers a structured approach for surgeons to tailor surgical strategies to each patient's deformity type. The present study tries to help establish an objective standard for secondary surgery of cleft nasolabial deformity for the first time.

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .