Patient treated Tertiary (3rd) Open Revision Septorhinoplasty with rib graft
This lady was unhappy with her nose from an early age due to a dorsal hump and deviation. She came to see me after 2 attempts to improve her nose by septorhinoplasty. She was unhappy with a bulbous, unsupported tip that had dropped and nasal obstruction.
At operation rib cartilage from a floating rib was harvested and any previous grafts recycled., The operative image shows the true central line of the nose (blue line) and the yellow lines show the deviation of the septum, tip deviation and tip asymmetry. The tip was also small and covered with fibrofatty scar tissue which was causing the bulbous shape. The nasal bridge was smoothed and excess removed, nasal bones re-aligned, spreader and septal extension grafts used to lengthen and straighten the short, deviated septum The tip was re-aligned, tip scar tissue removed and fine cartilage grafts used to give definition.