“How I Do It”
Revision Rhinoplasty – Bulbous / Deviated Tip
This patient had a primary rhinoplasty by another doctor about 5 years ago and she was unhappy with the result.
Her main issues were a crooked / deviated tip that was quite bulbous and lacked both support and definition.
Thick skinned patients are often faced with this type of problem and it takes a combination of critical maneuvers to achieve maximum tip refinement. Even then, the end point can be limited and the final result will be 12 months +.
Post operative care in revisions is especially important, often Kenalog / 5FU injections are needed. I highly recommend all my patients follow up with me periodically for at least the 1st year.
Hispanic Rhinoplasty – Crooked Nose
This patient was primarily unhappy with her frontal view which showed quite significant deviation of both the tip and the bony pyramid.
The side view showed a small and underprojected tip and a very small bump.
Correcting the crooked nose deformity is undoubtedly one of the hardest maneuvers in rhinoplasty. It takes a series of 15-30 moves to get things closer back into the midline. Complete straightening in some cases is not possible due to risk of destabilization of the nose.
In this case, we were able to achieve near perfect results essentially. Deviated septum surgery was also performed internally and breathing was greatly improved.