Revision Rhinoplasty Decades Later

This beautiful 68-year-old female presented to my clinic in early 2019 to discuss undergoing a revision rhinoplasty. The patient underwent a rhinoplasty in 1978 and was severely dissatisfied with her nasal appearance for more than 40 years. She was particularly concerned about a very slight curvature on her profile view as well as the excessively narrow appearance on frontal view and the “pointed” nasal tip.

I performed an examination of the patient and discussed her cosmetic desires. I recommended a very conservative reduction of her dorsal hump, nasal tip de-rotation with caudal extension grafting, and nasal tip repositioning. We discussed that it could be necessary to harvest supportive cartilage from her ear, based on her history of prior nasal surgery.

As is typical of a nose that has been excessively narrowed, the patient also had significant difficulty breathing and was hoping to obtain functional improvements as well.  As a board-certified otolaryngologist,  I always incorporate plans to maintain or improve breathing in my rhinoplasty patients.  In this case, I placed spreader grafts and lateral crustal strut grafts to help address the issues with her nasal collapse during breathing.

The patient is now more than a year out from her procedure.  Not only does she look great and feel great about her appearance, she also feels like she can breathe properly for the first time in more than four decades.  She is thrilled and I am ecstatic to have been able to help her improve her quality of life.

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