We Performed Again Complicated Revision Rhinoplasty in a Female Patient With Asymmetrical Nose

Revision Nose Job in Patient With Asymmetrical Nostrils

The patient, who had undergone rhinoplasty in England, applied to our clinic due to the emergence of asymmetry at the tip of the nose and different asymmetric reflections on the nasal dorsum over the years. We performed a micromotor-assisted revision rhinoplasty operation on the patient using temporal fascia and rib cartilage. You can find the pre- and post-operative images in the video above and the images below. It was observed that the patient's right alar cartilage outer crus was separated and caused a protrusion by sagging downwards on the nasal wing. It was observed that the patient's left alar dome area was cut and there was no connection between the outer crura and the inner crura, and that the outer crura shifted upwards, causing a notch at the tip of the nose. It was observed that the previously placed columellar strut graft was dislocated laterally, causing asymmetric columellar showing. This cartilage was removed. The right outer leg of the alar cartilages was repaired by placing a cartilage graft in between. The left alar dome point was redefined and the inner and outer crura were brought together. Septal graft was prepared with the tongue in groove technique and sutured with 4/0 PDS. Cup grafts were prepared and sutured with 5/0 PDS. Deviated septum areas inside the nose were resected.

The patient's nasal dorsum was smoothed by drilling with a micromotor tungsten probe. The right temporal fascia graft was taken and laid on the tip of the nose and the dorsum of the nose and used as a subcutaneous camouflage graft. During the operation, low-to-high osteotomies were made to both nasal bones with an ultrasonic device and the nasal bone was narrowed. Right alar base resection (alarplasty) was performed and the incision site was sutured with 6/0 rapid vicryl. The operation was terminated after bleeding control. The skin was laid back and the columellar incision area was sutured with 5/0 rapid vicryl. Internal silicone splints were placed in both nasal cavities and sutured to the nasal septum with 4/0 pds. A bandage was made with 3M brown micropore tape on the outside of the nose, and a thermoplastic external nasal splint was placed. The operation was terminated.

Search result link where you can find articles prepared by Dr. Murat Enöz about Revision rhinoplasty and published on this website (you can also reach previous articles by clicking "more posts" at the end of the page) >> https://www.ent-istanbul.com/search?q=revision+rhinoplasty 

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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