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PREOPERATIVE DIAGNOSIS:
- Nasal obstruction secondary to hypertrophic turbinates, residual deviated septum and external/internal valve collapse s/p rhinoplasty.
PROCEDURE:
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral alar batten and right rim 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.
- Right deep temporalis fascia harvest.
- Bilateral Turbinate outfracture.
- Revision Septoplasty.
Secondary Septorhinoplasty
FINDINGS: Thin dorsal skin; narrow lateral nasal walls, collapse external nasal valve with right greater than left due to concave native 9 mm lower lateral cartilages; narrow rims, cephalad rotated and retracted right ala; minimal anterior septum with slight saddling of cartilaginous dorsum, 3+ right bony septal spur identified abutting right lateral nasal wall; caudal septal deviation to left; bony septum present with minimal cartilaginous septum present; narrow right greater than left middle vault. Rib harvested by Dr. Wyatt.
COMMENT: This patient?s 4.5 month old post-surgery photos reveal a softer and natural profile. Patient continues to heal.
