Same child after NAM, pre-surgery.
After initial surgery.
Before NAM Treatment
NAM or Nasal Alveolar Molding
Nasal alveolar molding is a non-invasive (retainer) orthopedic type treatment done for infants immediately after birth until their first lip and nose surgery usually at age 3 to 4 months. The cartilage of the nose, and ears can be molded for the first 3 months of life. After 3 to 4 months, the cartilage remain the same shape forever. They will get larger, but not change shape. This treatment can be done because the mother's hormone estrogen is present in the infant for the first 3 to 4 months. The appliance required a dental mold of the child's upper jaw. The NAM is then modified weekly to change the shape of the gums & upper jaw. As soon as the nose cartilage is not being stretched, a nasal conformer is added to the appliance. It too is reshaped and re-positioned each week to reshape the nasal tip and alar cartilage. The NAM appliance is only effective if worn all the time.
NOTE:Since there is only a short window of time to effect the changes to the nose and jaw, treatment must start as soon as possible after birth.