Rhinoplasty - Surgical Revision

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Background: This young Bay Area woman, originally from Mexico, had facial trauma in her youth that resulted in a broken nose with a cosmetic deformity. She had undergone two previous nasal surgeries performed in Mexico, but was left with a deviated septum and a noticeable concavity of her nasal bridge.

My Assessment: "This patient is an attractive young lady with an unfortunate and obvious nasal deformity. Her Oakland area nose surgery case was challenging because of the two previous surgeries and the deviation caused by the nasal fracture. Often it is difficult to completely straighten a nose after it is broken, but after I examined her nose and discussed her goals I developed a procedure plan to correct the most noticeable problems."

Procedure: I performed open approach revision rhinoplasty procedure for this patient. During her plastic surgery procedure in San Francisco I carefully re-fractured her nasal bones and reset them properly. Then, using cartilage from another part of her nose together with AlloDerm (a permanent tissue matrix), I filled in the concavity. I also refined the nasal tip, taking care not to over-rotate it in the process, which would have given the nose an up-turned appearance.

Two Year Follow-Up: This patient's nasal concavity was greatly improved, but her nose was still showing some deviation, requiring a separate follow-up surgery. After her second revision rhinoplasty, this patient is showing good results, although a slight amount of the initial deviation still remains.

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