We Performed Again Complicated Revision Rhinoplasty Operation

Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella ...


The problems written in the above title can sometimes occur even after rhinoplasty operations performed only once. The patient, who had a primary rhinoplasty operation 2 years ago in a different clinic, applied to our clinic because of aesthetic and functional problems in the nose. On examination of the patient, the following were found:

- drooping columella
- asymmetrical nostrils
- incision scars
- asymmetrical and flattened nasal bone
- features of thick and fibrotic skin
- asymmetrical nose wings

In fact, when you look at the images, you can see how asymmetrical the anatomical structure of the nose is. The patient underwent revision rhinoplasty using temporal muscle fascia, removal and rib cartilages. Although the operation performed here is a secondary nose job; It was more difficult than many 4th and 5th rhinoplasty operations I have done. Marginal rim grafts were placed on the left nasal wing of the patient. Left-sided alar base resection was performed. He placed temporal muscle fascia and cartilage grafts on the dorsum of the nose. Septoplasty was performed. Alar dome points have been changed. Columellar strut graft and cap graft were placed. Right external spreader graft was placed. These grafts were sutured with 6/0 pds. The operation was terminated after skin suturing. The patient was also recommended to use a long-term nostril retainer device. It was a complicated and difficult operation.

While it is easy to excise, reduce or resect a tissue in the nose; It is not easy to produce from the same tissue or to increase its volume in a similar way ... In the case I shared with you here, cartilage powder, cartilage, bone powder can be used for nasal augmentation for a patient whose arch and cartilage tissue on the dorsum of the nose has been excised excessively. The reason why we lay the temporalis fascia on the dorsum here is that it is a soft and natural camouflaging tissue, a tissue with high blood supply, and it is a very suitable material especially for patients with thin nasal skin and excessive roughness under the skin. Placing only block cartilage is not very suitable in these patients as it may cause asymmetric reflections. Although various industrial membrane-shaped structures are also used for this purpose; It is not suitable as it may increase the risk of infection and tissue reaction.

Below you can see the patient's pre- and post-operative photos:

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Complicated Revision Rhinoplasty in Istanbul, revision nose job,Overreducted Nose Hump, Asymmetrical Nostrils, Asymmetrical Nose Bone, Hanging Columella

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
E-Mail: muratenoz@gmail.com 
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47



  
 


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