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Tertiary Revision Rhinoplasty

This is a quick example of a tertiary rhinoplasty outcome. So what is tertiary? Tertiary means this is the third time this young lady has had nose surgery. Unfortunately, she was involved in an accident many years ago that resulted in a number of cosmetic deformities to her nose. She underwent unsuccessful attempted rhinoplasty on two different occasions – performed by other surgeons.

Despite the prior surgeries, her nose was left as you see it here in the adjacent photo. At first glance, you will see that her nose is definitely deviated off to her right side.¬†Everyone’s nose is deviated to some degree – even after very good facial plastic and rhinoplasty surgery. But, in this particular case, the nose is still pretty far off the midline and is quite noticeable.In addition, her nose is fairly broad and flat across the tip region. In fact, she has what I would say is very poor tip definition. If you look at her nose more closely, you will literally see the outline of her lower lateral cartilages. These borders are indicated by the curved, red lines in the adjacent photo diagram. Normally, these segments of cartilage would be much closer together – near the middle of the nose. Unfortunately, in this case, they are spread out or splayed fairly wide apart – creating the look that her nasal tip is too broad.

External Revision Rhinoplasty

I ended up recommending an external revision rhinoplasty surgery to help reconstruct the nose. An external rhinoplasty is simply another term for an open rhinoplasty. Both names refer to a rhinoplasty where an incision is made between the nostrils – along the columella – and the skin is lifted up to expose the underlying anatomy. Although there is great debate as to whether or not this is the best way to perform revision rhinoplasty, I happen to believe this approach affords me better visibility.

In this case, I needed to fully deconstruct her nasal tip before reconstructing it. This means that the whole nasal tip had to be disassembled and put back together – but in a more appropriate manner. In cases like this where two prior, unsuccessful rhinoplasty surgeries were performed, it usually means there is insufficient amount of cartilage remaining to reconstruct the nose. Therefore, I ended up using cadaveric rib cartilage to rebuild her nasal tip region.

Dramatic Revision Rhinoplasty Results

Here are what I happen to think are her fairly dramatic revision rhinoplasty results. On her frontal view, you will appreciate just how much better her nasal tip is now – much better symmetry along with markedly improved nasal tip definition. In fact, her new nose now looks much more natural without any real distracting features – the essence of doing great rhinoplasty work in my opinion.

San Diego Revision Rhinoplasty

If you are looking to undergo revision rhinoplasty, do not hesitate in contacting our office today to schedule a personalized consultation with me – Dr. John Hilinski – one of region’s leading experts in cosmetic nose reshaping surgery.

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