Objectives:
Achieving symmetrical nostril appearance in patients with unilateral cleft lip after primary cheiloplasty and rhinoplasty is a matter of great concern for both parents and surgeons. Despite our utilization of the Tajima overcorrection technique in primary rhinoplasty procedures at our institute, we have observed a recurring asymmetry issue at around the age of one. However, it's important to note that this asymmetry appears to be relatively minor and stable over time. In this study, we present a longitudinal analysis of the outcomes of primary overcorrected rhinoplasty, shedding light on the entire disease course following treatment.

Material and Methods:
This retrospective study focuses on a cohort of 100 non-syndromic unilateral cleft lip patients who underwent cheiloplasty with primary Tajima overcorrected rhinoplasty at the Chang Gung Memorial Hospital Craniofacial Center between 2002 and 2003. The study aimed to evaluate the long-term symmetry of nostril shape in these patients through a series of digital photographs, encompassing both worm's-eye and frontal views, taken at various ages: 1.5, 5, 10, 15, and 18 years old. Symmetry was assessed using anthropometric measurements, and the data were analyzed using linear regression with a generalized estimated equation model.

Result:
Preliminary data from our study demonstrate notable improvements in nostril asymmetry among both complete and incomplete unilateral cleft lip patients during the follow-up period. Significant improvements in both nostril height and width are evident when comparing measurements taken at the age of 18 and 15 years to those at the age of 1 year, with p-values < 0.05.

Conclusion:
This study comprehensively explains the disease course for unilateral cleft lip patients who have undergone primary overcorrected rhinoplasty. Our result demonstrated that the asymmetry of the nostril regarding height and width reach stability at the age of 15. These findings will assist surgeons in making informed decisions regarding the timing of secondary rhinoplasty, particularly in cases where the initial results are unsatisfactory.

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