I have a cleft lip/palate which also affected my nose.  My nose on one side is deflated and the other side is larger.

I have a bone graft that builds up my nose so it is not flat.  It goes to the tip of the nose.  It causes me discomfort and the tip of the bone is apparent thru my skin.  I want to have my nose reconstructed and the bone graft taken out.  Is it doable to put fillers in the tip to make it look like a nose and to reconstruct the deflated side to match the other side so it will be more symmetrical?

There is one major problem with your current reconstruction.  The bone graft should not extend into the tip.  Surgeons often try this technique to support the tip, but normal tips do not get their support from the bridge but rather from the tip cartilages, which allow the tip to be mobile.

Asymmetry is the rule in cleft noses.  Your surgeon has made a good beginning, and if the bone graft is otherwise fine it can be shortened and cartilage from the ear or septum can be used to fix the tip independently.  That, plus whatever other procedures you need for your cleft shape, will make a big difference.  If the bone graft looks like it may poke through the skin, you should get advice sooner rather than later.

Find an experienced surgeon whom you  trust and whose cleft results you like.  Good luck.

Thank you for describing the details of your cleft lip/nose deformities. Without viewing your photographs it is difficult to suggest the appropriate surgical plan.  However, it seems like the protruding bone graft needs to be excised, wait a few months for healing, and then reassess the situation.  A cartilage graft harvested from your septum or your ear is a good source to repair/reconstruct the collapsed and asymmetrical part of your nose.  This challenging procedure should be performed by an experienced board certified plastic surgeon.

F. Mahjouri, M.D., F.A.C.S.