Patient-Reported Esthetic Outcomes Following Secondary Rhinoplasty in Adult Patients with a Cleft lip and Palate

Objective: Secondary rhinoplasty is a frequently requested revision procedure in patients with a history of cleft lip and palate (CLP). The satisfaction of patients with the esthetic outcome of the procedure has been infrequently studied. Design: Adult patients with CLP who had undergone a secondary rhinoplasty between 2009 and 2019 were identified in a cross-sectional cohort that had filled the FACE-Q rhinoplasty module. The effect of the cleft type and the number and timing of the nasal revision surgeries were evaluated. Results: Forty participants were included, median age of 26 years (range 18-59 years). Nine (23%) participants had a history of bilateral CLP. The median time form the last nasal operation to the study was 4.5 years (range 16 days to 10 years). The participants reported being satisfied with the appearance of the nose (median score 52, interquartile range [IQR] 44-60) but the satisfaction with the appearance of the nostrils (median score 44, IQR 30-64) was below the normative value for the scale. Patients with a history of bilateral CLP reported worse satisfaction across all the aspects of health-related quality of life assessed (P < .05 for all). No association was observed between the age at the first open rhinoplasty and satisfaction with the appearance of the nose or the nostrils. Conclusions: Following secondary rhinoplasty, adults with CLP are, in general, satisfied with their nose but less so with nostrils. Compared to unilateral CLP, bilateral CLP is associated with a worse health-related quality of life.