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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to external/internal valve collapse, deviated septum following 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 tip support with placement of columellar strut.
- Repair of nasal vestibular stenosis with reconstruction of internal valve collapse with placement of bilateral spreader grafts.
- Graft, right and left ear cartilage conchal composite grafts.
- Right deep temporalis fascia harvest secondary to thin skin.
- Revision Septoplasty
- Bilateral Turbinoplasty.
- Repair of nasal vestibular stenosis with reconstruction of rim collapse with retracted with placement of bilateral conchal composite grafts (skin & cartilage).
- Repair of nasal vestibular stenosis with repositioning of lower lateral cartilage secondary to vertically-oriented positioning.
FINDINGS: Native 9 mm lower lateral crura (LLC) on left, 11 mm LLC on right, left base more cephalad oriented, external valve collapse, narrow right greater than left internal valve narrowing, some septum intact following procedure and vertically-oriented LLC and weak rims.
COMMENT: This is a patient who wished to improve her breathing and soften the appearance of her nose. 4 month post-operative photos reveal an improved profile. Patient continues to heal.