We Performed a Micro-motor Assisted Third Revision Male Rhinoplasty Operation

Tertiary Revision Nose Job For a Patient with Thick Skin and a Droopy, Asymmetric Nasal Tip

The patient, who had previously undergone rhinoplasty twice at a different clinic, presented to our clinic due to breathing difficulties and aesthetic concerns regarding the shape of his nose. Examination revealed the following findings:

- Deviation of the nasal tip to the right

- Caudal septal deviation protruding into the left nostril

- Weak nasal tip support and a drooping nasal tip

- Irregularities along the nasal dorsum

- Asymmetry between the nostrils

- A micromotor-assisted open-technique tertiary revision rhinoplasty was planned for the patient.

Operative note: Following a columellar incision, the nasal tip skin was elevated. Two-level subcutaneous dissection and subcutaneous tissue resection were performed. Caudal septoplasty was carried out. Nasal tip cartilage support was enhanced by placing a septal extension graft using the "tongue-in-groove" technique. A right marginal rim graft and a cap graft were placed. Irregularities on the nasal dorsum were corrected using a micromotor with a tungsten probe. Bilateral low-to-high osteotomies were performed using an ultrasonic device. The skin was redraped and sutured. Bilateral internal silicone splints were inserted, and the nose was taped.

One week later, the silicone splints were removed, and the nose was re-taped.

As seen in the photographs, the nasal tip axis and nostrils appear more symmetrical, and the nasolabial angle has normalized.

This case represents a typical example of natural-looking male revision rhinoplasty.

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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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