Patient treated with Secondary (2nd) Open Revision Septorhinoplasty
This lady came to see me having undergone a rhinoplasty to make her nose more feminine. Unfortunately she had not noticed a great change post surgery. Her main concerns were a low ill-defined tip that dropped further when she smiled. Her nostrils also elongated downwards on smiling and generally she felt her nose was not feminine.
At operation, the side view image shows the actual position of the poorly supported tip (yellow arrow) and the desirable level achieved at revision (green line). The front view shows the correct midline (blue line) and the deviation, rotation and asymmetry of the septum and tip (green lines). The nasal bones were straightened and brought in, the bridge smoothed, the nasal septum straightened with spreader grafts, the tip supported with a septal extension graft and refined with fine tip grafts.