Open Rhinoplasty with Abbe Flap: Transforming Lives with Complex Deformity Correction

This case study highlights the remarkable results of open rhinoplasty with Abbe flap reconstruction at our hospital in India, offering hope and transformation for individuals with complex facial deformities.

Facing Challenges:

A young woman, previously treated for bilateral cleft lip deformity, sought further correction due to:

• Excessive upper lip scarring
• Obtuse nasal tip deformity
• Missing columella
• Broad alar base deformity
• Whistling deformity of the upper lip

These concerns not only impacted her appearance but also caused functional difficulties.

Expert Intervention:

Our team, led by a renowned plastic surgeon, devised a comprehensive treatment plan:

1. Costal Cartilage Grafting: Cartilage grafts harvested from the ribs addressed both nasal and upper lip concerns.

2. Open Rhinoplasty:

• Osteotomy and Cartilage Rearrangement: The nasal bone was reshaped, and nasal cartilages were meticulously repositioned.
• Nasal Tip Correction: Harvested costal cartilage grafts corrected the obtuse tip and augmented the flattened nasal bridge.
• Columella Reconstruction: Prolabial tissue was ingeniously used to recreate the missing columellar structure.

3. Abbe Flap Reconstruction:

A crucial step involved an Abbe flap, a skin, muscle, and blood supply-rich flap raised from the lower lip and meticulously sutured to the upper lip’s prolabial defect. This flap remained attached for three weeks for optimal blood supply before separation.

Remarkable Outcome:

The surgery achieved:

• Significant functional improvement
• Aesthetically pleasing results
• Correction of both nasal and upper lip deformities

This case showcases the transformative power of open rhinoplasty with Abbe flap reconstruction, offering hope and improved quality of life for patients with complex facial deformities.