Rhinoplasty, commonly known as a ‘nose job’ is a surgical procedure for repairing or altering the appearance of the nose.

Reconstructive surgery may be needed if the nose is damaged. For example, in a car accident – as well as in cases where it did not form properly before birth. Many people born with clefts of the lip and/or palate have significant nasal deformities, which can reduce the nasal airway, leading to breathing problems. Rhinoplasty is necessary to improve both the function and appearance of the nose.

Cosmetic rhinoplasty refers to surgery that alters the shape or size of the nose purely for aesthetic reasons. Because the nose occupies a central and sizeable part of the face, imperfections can draw attention away from more attractive features, such as lips and eyes. People who are self-conscious about the size or shape of their noses may lack confidence and feel unattractive and unworthy.

Rhinoplasty is often life-changing. Hardly surprising then, that it is one of today’s most common cosmetic procedures.

Cleft rhinoplasty

Cleft rhinoplasty aims to improve both the appearance and function of the nose. Renowned plastic and reconstruction surgeon, Dr Bruce Lelala, describes the procedure as “complex and challenging,” as it typically involves repositioning skin, cartilage, mucosa and bone.

As with cosmetic rhinoplasty, the benefits are not only physical. Nose restoration has a profound impact on the psychological well-being of both the patient and his or her parents.

At what age is cleft rhinoplasty done?

Because the lip and nose are anatomically connected, primary reconstructive rhinoplasty is performed at the same time as cleft lip repair – ideally when a child is between the age of 2-6 months old.

During surgery, the lower lateral cartilages are repositioning to improve the shape and symmetry of the nose, allowing it to grow and develop normally.

Is one operation enough?

Multiple operations – classified as primary, intermediate and secondary repairs – are needed as the patient grows.

Intermediate rhinoplasty is usually performed between 4 and 6 years of age, before the child starts school. This allows the surgeon to perform any minor lip revisions that may be necessary, as well as achieve better nasal tip symmetry.

Secondary rhinoplasty occurs after facial growth is completed – around 14 to 16 years for girls, and 16 to 18 years boys. At this stage, it may be necessary to place cartilage grafts inside the nose for support and reinforcement.

Benefits of cleft rhinoplasty

Children born with cleft conditions may be stigmatised, teased at school and isolated by communities – all of which can lead to major mental health issues. Cleft rhinoplasty provides a tremendous psycho-social benefit, allowing the child to live a normal life.

“I’ve seen first-hand how these operations change lives,” explains Dr Lelala. “The kids perform better in school and their grades improve. Their confidence is restored and they participate more frequently in social gatherings and sport. The parents’ mental well-being is also affected positively.

“It is indeed a life changing operation!”


FOOTNOTE: Dr Bruce Lelala is an internationally credentialed Operation Smile cleft surgeon. He has been involved in cleft surgery missions on the African continent and abroad. Follow Dr Lelala on Facebook and Instagram or visit www.drbrucelelala.co.za.

Dr Lelala holds a Bachelor of Science (BSc) from the University of the Western Cape (UWC), a Bachelor of Medicine and Bachelor of Surgery (MBCHB) from the University of Kwa-Zulu Natal (UKZN), a Diploma in Anaesthetics (DA) from the Colleges of Medicine of South Africa (CMSA), a Postgraduate Diploma in Business administration (PDBA) from Gordon Institute of Business Science (GIBS), a Masters in Medicine (MMEd) from the University of Cape Town (UCT), a Fellowship in Plastic and Reconstructive Surgery from CMSA and a Fellowship in Microsurgery and Oncoplastic Breast Surgery from the University of Nottingham (UK). He is also a member of the Society of Rhinoplasty Surgeons of South Africa (SORSSA) and a member of the American Society of Plastic Surgeons.

Share this post on social media