Dr. Rachel A. Ruotolo

10/27/2025

Hi 👋🏼 everyone!

It’s !! 🖊️🖊️

Today, I’m highlighting the intra-op markings of a recent RIGHT sided complete cleft lip 👄 and nasal 👃🏼 reconstruction. In this video 🎥 , I’m highlighting the importance of:

✔️ Marking the ENTIRE white roll to confirm accurate position of Cupid’s bow and Nordoff’s point
✔️ The arc of the rotation flap
✔️ The importance of checking and re-checking the markings MULTIPLE times and even redoing them if necessary. Every millimeter 📏 counts!!

Details. Details. Details. 🤓👌🏻

Stay tuned for updates on this baby’s progress!

As always, leave your questions and comments below. 👇🏼

Mission: Transforming children’s lives one smile 😀 at a time. 👍🏼

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/23/2025

Happy Thursday!! 🤗

Today I’m discussing SYNDACTYLY and POLYSYNDACTYLY.

Syndactyly is the “webbing” or fusion of fingers and toes.

Polydactyly is when the baby is born with extra fingers ☝🏻and/or toes🦶🏻.

POLYSYNDACTYLY is when the baby is born with FUSED and EXTRA digits.

Surgery is typically performed before 1 year of age. The benefit of this age range is that the post operative course requires casting for ~3 weeks. This is very well tolerated in babies. In addition, at this age, the harvested skin grafts (if needed) are smaller and thus heal much quicker than larger grafts in older patients.

We stress the importance of proper postoperative care including dressing changes 🩹 immediately after cast removal and taping for one year postop to prevent creeping within the webspace.

Goals of repair include recreating the webspace and lining the sides of the newly separated digits with either skin grafts or local skin flaps. Skin grafts, if needed, are harvested from the lower abdomen for upper extremity cases and from the ankle for lower extremity cases. These areas are a great color match and the scar ends up nicely hidden and barely discernible! 👌🏼

Finally, in situations where there are multiple sequential digits involved, sometimes the surgery needs to be staged. If staging is needed, these are usually scheduled approximately three months apart.

Any questions about syndactyly or polysyndactyly?? Leave them in the comments below 👇🏻.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/21/2025

Hi 👋🏼 everyone!

As promised, take a moment to watch 👀 this video 📹 where I discuss the indications and the surgical technique of a cleft lip ADHESION!

What is a cleft lip adhesion?? 🤔

A cleft lip ADHESION is the first of 2 surgeries performed on a cleft lip. Two staged cleft lip repairs are typically performed in babies with a very wide unilateral or bilateral complete cleft lip when:

1. NAM and/or PLANA are NOT available to the patient

OR…

2. The baby isn’t able to tolerate NAM or PLANA

In this video I discuss:

WHEN a cleft lip adhesion is indicated and WHICH patients most benefit from this procedure.

Watch until the end of the video to view photos of my sweet patient BEFORE and AFTER his bilateral cleft lip adhesion.

As always, leave your questions in the comments below 👇🏼.

Mission: Transforming children’s lives one smile at a time.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/17/2025

10/16/2025

Happy Thursday, everyone! 🎉

I am excited to share another heartwarming testimonial from the parents of a following his bilateral cleft lip and palate repair.

Watch this brief video to see his journey so far: 6 months following his cleft lip 👄 and nose 👃🏼 repair, and 1 month following cleft palate repair (and to read his Mom’s sweet words 🥹🩵).

I am so incredibly grateful 🙏🏻 for the outpouring of love and appreciation I receive from my patients and their incredible families. 🥹

(I will keep you posted on this little guy’s progress. 😊)

Mission: Transforming children’s lives, one smile 😃 at a time.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/15/2025

Hi 👋🏼 everyone!

This 11 year old girl presented to me with her parents with concerns about her protruding ears 👂🏻. She is seen here 1 year following her otoplasty.

Otoplasty (aka ear pinning) is a surgery to correct prominent ears. This can either affect one or both ears, and both ears can be affected differently.

No two surgeries are the same. Each one is individualized to the patient’s anatomical needs. Take a moment to look at people’s ears around you....the differences are vast! It is so important to maintain a NATURAL appearance to the ears. They shouldn’t be set too close to the head and shouldn’t have any sharp edges, just natural curves. 👍🏻👍🏻

This surgery is typically thought to be reserved for little children, however, this is not true at all. Many of my patients are teenagers and adults. Timing of surgery is simply an individual choice for each patient. There is no right or wrong time, there is just a “best time” for every individual. The earliest I will perform otoplasty, however, is 4 years of age.

If you or someone you know has been considering this surgery, feel free to review my before and after gallery on my website or IG/FB/Tiktok pages and contact my office to set up a consultation to see if you are a candidate for surgery.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (via parents) to appear on my website and social media pages.

10/14/2025

Hi 👋🏼 everyone!!

Remember yesterday’s !? He is seen here BEFORE and immediately AFTER his bilateral cleft lip 👄 and nasal 👃🏼reconstruction.

Watch 👀 this video 🎥 to view his on-table cleft lip 👄 and nasal 👃🏼 transformation!

Stay tuned for updates on his progress over the next few weeks and months!

Mission: Transforming children’s lives one smile at a time.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/13/2025

Hi 👋🏼 everyone!

It’s !! 🖊️🖊️

Today I’m highlighting the intra-op markings of a recent BILATERAL cleft lip 👄 and nasal reconstruction. These repairs are sometimes harder for people to visualize, so today I am taking you through the markings step by step!👍🏻

Stay tuned for updates on this baby’s progress!

As always, leave your questions and comments below. 👇🏼

Mission: Transforming children’s lives one smile at a time. 👍🏼

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.

10/10/2025

Hi 👋🏼 everyone!

Watch the following Reel 🎥 cataloging this ’s progress over the last six years following his left unilateral cleft lip and nasal reconstruction.

Where does time 🕰️ go?! 🤷🏻‍♀️

It is so very important for parents to see and understand the many changes that occur to the lip, nose and scar during the months and years following their child’s cleft repair.

The lip is often pink and firm for months after the surgery. The scar may also contract, causing shortening of the lip, making it appear as if the cleft is recurring 😳 (note these changes in some of this child’s early pictures).

I try my best to reassure parents along the way, as SO many changes happen over time. Some changes will require operative intervention, and others just need time and (of course) patience. 😇 👼

As you can see in this video 🎥, patience and time ⏰ are essential in allowing the lip and nose to soften and settle. 👌🏻

Mission: Transforming children’s lives, one smile 😃 at a time.

These images are the property of Dr. Rachel A. Ruotolo and NYPSG and are not authorized for use by any other party.

This is my actual patient with real results who has given informed consent (directly or indirectly via parents) to appear on my website and social media pages.