Nasoalveolar Molding Chicago
Nasoalveolar molding, or NAM for short, is a nonsurgical, minimally invasive approach to reshaping the lips, gums, and nose prior to cleft lip and palate surgery.
Children born with an incomplete formation of the upper lip, or a cleft lip, often require surgical intervention to correct the problem so that breathing, eating, and speaking can develop normally. The same applies to a cleft palate, a similar defect in the roof of the mouth. While these can occur individually, they frequently appear together, exacerbating the severity of the condition as well as the procedures required to repair them.
Nasoalveolar molding is an innovative method used primarily in children that have particularly wide or large clefts. The NAM technique uses a plastic-like plate to reduce the cleft before the initial cleft lip repair, often resulting in fewer overall procedures your child may need over the course of their development.
IS MY CHILD A CANDIDATE FOR NASOALVEOLAR MOLDING?
Traditionally, a child with a complete cleft lip, including a cleft in the gum, or wide cleft lip and palate might require multiple surgeries to fully restore appearance and functionality to the lip, nose and mouth. Nasoalveolar molding is not an alternative to surgery; however, it has greatly improved cleft care by reducing the size of the cleft prior to the initial surgery and decreasing the number of necessary procedures.
NAM is used on infants to gently direct the position of the gums, nose, and lips while the tissue is soft and easily formed. If your newborn is affected by a cleft lip or palate, consult with a plastic surgeon to see if nasoalveolar molding is a viable treatment option.
HOW NASOALVEOLAR MOLDING IS PERFORMED
Nasoalveolar molding can begin as earlier as three to four weeks of age. The customized plastic plate is shaped specifically for your baby’s mouth and looks much like a retainer. It is held in place with rubber bands and is usually taped to the baby’s cheeks to avoid being dislodged.
Infants wear the molding plate continuously, even when feeding, for the first few months after birth. Every one to two weeks, the plate is modified in order to mold the gums to close the gap between them.
NAM not only reduces the cleft inside the mouth, but also narrows the gap in the cleft lip, as well as lifts and narrows the nose. The technique is not painful; instead, nasoalveolar molding gently guides the growth of affected areas.
Cleft lip and palate surgery is performed after the molding regiment is complete, typically between three and six months of age. During this procedure, flaps of tissue are created and gently brought together to close the gap.
RECOVERY AND POTENTIAL RISKS OF NAM
There is no recovery period for nasoalveolar molding, since it is a nonsurgical method. There is, however, a recovery period after the cleft lip and palate repair. The only known risks associated with NAM are skin and gum irritation, since it is a minimally invasive technique that does not require any incisions or surgical intervention by itself.
WHAT DOES NASOALVEOLAR MOLDING COST?
NAM is designed to reduce not only the number of procedures required to treat a cleft lip and palate, but also the overall cost of the treatment. NAM therapy costs can range from $4,000 to $6,000 depending on the recommended treatment and extent of the cleft. Be sure to discuss all costs with your plastic surgeon during your consultation. Your medical insurance may cover some or all of the cost associated with nasoalveolar molding; contact your health insurance provider before your child undergoes the procedure.
SCHEDULE A CONSULTATION
The Plastic Surgery Clinic of Chicago is comprised of experts in pediatric care and reconstructive surgery. At our clinic, your child’s care will be in the hands of a board-certified plastic surgeon that has specialty training in both NAM and cleft surgery. You can rest assured that the personalized attention your child gets now is the same care that he or she will receive throughout their entire treatment plan. For questions about nasoalveolar molding, call our clinic to schedule a consultation.
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This is a great case to highlight the complexities associated with creating an aesthetic tip and how small changes can yield significant aesthetic improvement. In this case, the patient had a droopy tip, hanging columella, and too much nostril show. In the post-operative views you can visualize a tip that is lifted, more projected, and the presence of a more aesthetic alar-columellar relationship. Happy for this patient and her beautiful and natural result. Posted with permission.
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Proud of our research team for getting this published. In this article, we developed a unique risk assessment tool to predict major complications in facial aesthetic surgery. Thank you to the Aesthetic Surgery Journal for publishing our work.
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The hardest type of rhinoplasties for plastic surgeons to perform are cleft rhinoplasties. A major reason is that the anatomy of the nose and midface are asymmetric, therefore, you have an asymmetric nose sitting on top of an asymmetric midface. In this case, I used rib cartilage to rebuild the cartilage of the nose and fat transfer to improve asymmetries of the midface and lips. In the post-operative frontal views, you can see a straighter nose, the tip has been lifted, and the right nostril has been brought down and inwards. On profile view, you can see the dorsal hump was lowered, the tip of the nose has been lifted, rotated, and refined. The fat was placed in the cheeks and upper lip to improve the midface deficiency that is common in cleft lip patients. Posted with permission.
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Plastic surgery can be dramatic or understated. This is a before and after with subtle changes to improve the proportions and aesthetics of the nose in a natural way. This patient wanted only small changes of the dorsum and tip. In the post-operative photos, you can visualize the dorsal hump has been removed and the tip has been refined, slightly rotated and projected. Posted with permission.
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Couldn’t be happier for this beautiful patient and her natural before and after results. This patient is 3 months out from a deep plane or sub-SMAS facelift, neck lift, and facial fat transfer. Pay close attention to the neck, jawline, and midface or cheeks. In the post-operative views you can see a well-defined neck and jawline. The face appears less bottom heavy, there is restoration of the midface volume, and the overall facial configuration is more heart-shaped and youthful. Posted with permission.
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It’s been a minute but this is a great before and after of a facial feminization case and this patient is only 6 weeks out from surgery. Pay close attention to the hairline, the forehead, orbital rims, eyebrows, nose, chin and jawline. Does this patient look like they had major surgery 6 weeks ago? Posted with permission.
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Check out this interesting rhinoplasty case where I performed a combined primary rhinoplasty and sliding genioplasty. Fixing the crooked or deviated nose is very challenging for all rhinoplasty surgeons and the goal is to achieve a straighter nose because a perfectly straight nose does not exist. On the frontal view, you can see a nose that is midline and with beautiful dorsal aesthetic lines. On the profile view, you can visual a nice nasal profile with a slight break at the tip. The sliding genioplasty complements the nose and improves the overall proportions and balance of the face. A chin implant would not be able to achieve this amount of chin augmentation or chin length. Posted with permission.
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It’s never too early to starting thinking about that summer body. This patient underwent a mommy makeover or a breast reduction/lift and tummy tuck. Pay close attention to the belly button, this patient had an umbilical hernia, which made the reconstruction of her belly button even harder. Most plastic surgeons take their time trying to make the belly button look as natural as possible since the appearance of the belly button can be an obvious sign that the patient had a tummy tuck. Posted with permission.
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