LAM FACIAL PLASTICS

Dear Dr. Lam:

My son has cleft pilate (one side) and the airway is so tight in the nose and the nose doesn't grow at all. He is 12 years old and he has been done two surgery's try to open up the airway, but the scar is so sever and almost close the airway again after the sugery .

I am thinking or dreaming : Is there any way to expend / open the nose by inserting a device ( kind of the device to expend the jaw in the mouth) into the nose and gradaully open the nose and make it lager enough to breath freely.

Thank you very much.
Jane

hmmm, i do not know. i know that one can bougie the esophagus, which i did in my residency but i think the nose could close down more with such a mov. however, i really do not know. i am sorry.

Thank you very much., Dr. Lam.

I guess my son will need some surgery in the furture for the nose work, but I am so worry about the scar problem. He has been done two suegeries and the surgery did not make the scar smaller instead of making bigger. I read a article long time ago and it is said there is some the special way to minimum the scar tissue doing the surgery. Do you hear anything about it?

Thank you again.

if you are talking about keeping the nostril from shrinking that is a more complicated issue and the only thing i could thing about is to keep some kind of stent in the nose for long term but that actually if it causes too much pressure could still lead to scarring. as far as skin surface scarring, the best way to minimize that would be to treat the area very carefully and then subsequently if the scar starts to become apparent is to inject it with 5-FU and use KTP laser to manage it. i would also recommend using silicone gel postoperatively to minimize scar tissue.
best,
sml

Thank you very much.

I may bring him to see you this summer.

ok. would look forward to it.