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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to deviated septum, turbinate hypertrophy, internal valve collapse and convex right nasal bones causing nasal inlet obstruction.
- Turbinate Hypertrophy.
- Septal Deviation.
PROCEDURE:
- Submucous resection and partial resection of left turbinate and submucous resection and partial resection of right turbinate.
- Complex septoplasty (closed approach) for correction of deviated nasal septum.
- Repair of nasal vestibular stenosis secondary to bilateal external valve collapse with bilateral subcartilaginous and lateral crural strut grafts.
- Repair of nasal inlet obstruction secondary to flat, convex right nasal bone.
- Repair of nasal vestibular stenosis secondary to right internal valve collapse with placement of right triple-layered spreader grafts and left single spreader graft.
- Right Deep Temporalis Fascia Graft Harvest.
- Repair of nasal vestibular stenosis secondary to right and left external valve collapse with release and repositioning of right and left lower lateral cartilages.
- Repair of nasal vestibular stenosis secondary to tip ptosis with placement a columellar strut.
Open SeptoRhinoplasty, Platelet gel application
FINDINGS: Collapsed external valve and left greater than right malpositioned lower lateral cartilages (LLC), Large septal spur to left and posterior right deviation with caudal septum deviated to left, narrow 3+ right greater than left middle vault, flat, convex right nasal bone, nasal tip deviated to left secondary to cephalad orientation of left lower lateral cartilage and pre-maxillary defiency (left), left LLC caudally displaced as compared to left, bilateral opposing septal tears secondary to 3+ spur with fascia and mucoperichondrium placed. Native lower lateral cartilages: 13 mm.
COMMENT: This is a patient who had trouble breathing and desired a softer nasal appearance. 15 month photos reveal an improved profile.
Bilateral (Upper and Lower) fat repositioning, and Blepharoplasty
