Primary nasal correction at the time of rotation-advancement of the lip has been rendered practical by developing a symmetrical nasal platform by presurgical orthodontics and a gingivoperiosteoplasty. The nasal correction involves unilateral columella lengthening, alar cartilage positioning, and alar base cinching to present a nose within normal limits. This is accomplished before the age of recall, and by avoiding retention of the nasal deformity through childhood, it by-passes the ridicule that invariably accompanies it.
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Millard et al. (1998) studied this question.
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