We Performed Revision Rhinoplasty and Septum Perforation Repairing Surgery

Revision Nose Job (Deviated Nose Aesthetic) and Septal Hole Closure With Temporal Fascia

A patient who had undergone open technique septorhinoplasty at a different clinic one year prior. The patient was found to have a deviated nose deformity (the yellow dashed line in the image above shows the nasal axis deviated to the left) and a septum perforation measuring approximately 6x8 mm, with dry, crusty mucosa surrounding the septum. It is seen that the patient's nasal axis is deviated to the left and there is a collapse in the right nasal valve area.

In the image above, it is seen that hanging columella is present and the columella is treated by shaving.

The image above shows the nasal fossa smaller than the left, the left nostril rounded and wide, the right nostril ellipsoidal and small, and the right ala retracted. During the revision rhinoplasty, a right marginal rim graft was placed and a right alar base resection was performed. The patient's nostrils appear much more symmetrical after the surgery.

The image above shows a preoperative nasal axis deviation to the left, with collapse of the right nasal valve. The patient's left spreader graft was removed, and the left upper lateral cartilage was reduced. A right spreader graft was placed. Bilateral low-to-high osteotomies were performed, and the protruding areas were drilled and reduced with a micromotor. Postoperatively, the patient's nasal axis is completely midline. It is observed that the tip of the nose also became midline and symmetrical by placing the right rim graft, right alar plasty and tip grafts.

Photos taken from the left diagonal angle show asymmetry in the left supratip area, projecting outward. A much more symmetrical appearance was achieved after the operation.

In the image above, the left photograph shows a 6x8 mm nasal septum perforation with dry edges in the anterior portion of the nasal septum. The dead and dry epithelial area around the perforation was excised. Temporal fascia was harvested from the right temple, and this graft was placed within the septal opening in an hourglass shape, and the edges were sutured to the septum with 4/0 PDS suture material.

In the images showing the inside of the nose taken from this angle, the nasal septum perforation is completely covered by the fascia.

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

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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