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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse following rhinoplasty, residual deviated septum, and convextcolumella.
PROCEDURE:
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral lateral crural strutgrafts.
- Repair of nasal vestibular stenosis with reconstruction of tip support with placement of columellar strut.
- Repair of nasal vestibular stenosis with reconstruction of internal valve collapse with placement of bilateral spreader grafts.
- Repair of nasal vestibular stenosis with reconstruction of deviated columella secondary to convex/concave medial crura with placement of right medial crural batten graft.
- Left deep temporalis fascia harvest.
- Revision Septoplasty.
FINDINGS: Narrow bilateral external valve with right worse than left and divided dome with 3+ concavity; external valve collapse with left greater than right, medial crural right concave and left convex; caudal septum deviated to left with residual left spur, LLC approximately 6 mm in width.
COMMENT: Male patient who had trouble breathing and wanted to soften appearance of nose. I year post surgery photos demonstrate corrected septum and an improved profile.
Other procedures performed: Bilateral upper & lower (fat repositioning & transconjunctivalorbicularis excision) Blepharoplasty, chin implant, submental liposuction, platelet gel application.
