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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse, s/p rhinoplasty, hypertrophic turbinates.
PROCEDURE:
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral lateral crural strut grafts.
- Repair of nasal vestibular stenosis with reconstruction of over-rotated nose with placement of septal extension graft.
- Repair of nasal vestibular stenosis with reconstruction of internal valve collapse with placement of bilateral extended spreader grafts.
- Repair of nasal vestibular stenosis with reconstruction of tip support with placement of columellar strut.
- Graft, left cartilage.
- Right deep temporalis fascia harvest.
- Revision septoplasty.
- Submucous resection of right inferior turbinate. Submucous resection of left inferior turbinate.
Secondary septorhinoplasty, platelet gel application.
FINDINGS: Lower lateral cartilage (LLC) remnant: 7 mm at widest dimension, truncated and s/p dome division, right weakness at external valve greater than right at LLC and rim; over-resected anterior and caudal septum; left greater than right narrow middle vault, C-shaped septum with mid deviation to right and caudal deviation to left and vomer previously resected and bony septum intact; 3+ scar encasing tip with tip skin adhered to scar. Ala asymmetric with left more convex than right and right base lower than left. Hanging ala.
COMMENT: His 7 month post-op photos reveal a softer nose.
