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Preoperative Diagnosis:
- Nasal obstruction secondary to external/internal valve collapse, residual deviated septum, hypertrophic turbinates following rhinoplastyX2.
- Residual deviated septum.
- Hypertrophic turbinates.
Procedure:
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral alar batten 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.
- Repair of nasal vestibular stenosis with reconstruction of shortened, over-rotated caudal septum with placement of shield (tip) graft.
- Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral rim grafts.
- Revision Septoplasty.
- Bilateral turbinoplasty.
Tertiary Septorhinoplasty, platelet gel application.
Findings: Narrow left greater than right external valve and rim; Grafts harvested from rib, left alar retraction, narrow left greater than right middle vault, over-resected lower lateral cartilages (LLC) with only dome and medial crura present with left dome divided, tip encased with scar with tedious dissection with thin skin, septum deviated to left, under-projected tip, cartilage graft over mid-dorsum and over-rotated/shortened tip.
Comment: This patient desired a rhinoplasty revision (different surgeon) where she wished to improve her breathing and soften her nasal appearance. 4 month post-operative photos reveal a softer and improved appearance of the nose. Better breathing was reported as well.
