Revision Rhinoplasty Q&A
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What Needs Done During Revision Rhinoplasty?
asked 1 year ago by ginncha
Latest answer by David Mabrie, MD
Question viewed 529 times
Tags: nose tip, female, deformity, hump, open, osteotomy, sensitive skin, wide
hello I had a closed rhinoplasty 20 years ago and the doctor just raspted the hump and left an open roof? and have a tip deformity.
I saw 2 doctors and the first said 1 need to do and open rhinoplasty and do an osteotomy to close the open roof and other said i need open rhinoplasty but no osteotomy just adding graft to close open roof.
what should i do. i don't think that my bone is to wide but sometimes my nose bone is sensitive when i put glasses
12 answers to What Needs Done During Revision Rhinoplasty?
+1
What could be done to your nose with revision Rhinoplasty
From your photos, it does appear that you have an open roof deformity of your nasal bones as well as very asymmetric tip cartilages. The open Rhinoplasty, with possible ear cartilage tip graft is required to make the nasal tip more symmetric. The two opinions: osteotomies to close the open roof deformity or the use of an onlay graft to cover the deformity over are the two recognised ways to treat an open roof deformity.
IMHO, the onlay graft to cover the open roof...
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+3
Revision rhinoplasty for open roof nasal deformity
Thank you for submitting your photos. They are very helpful in recommending the most appropriate treatment. Based on the excessive width of the nasal dorsum, I agree that lateral osteotomies are needed. I cann't comment on the necessity of spreader grafts based on the photos. The open vs closed approach depends on the surgeon's preference in dealing with the tip asymmetry. I think in your case, a conservative nostril narrowing will also be useful.
Maurice M. Khosh, MD
New York Facial Plastic Surgeon
New York Facial Plastic Surgeon
+2
Surgical plan for revision rhinoplasty.
Ginncha, although an accurate complete analysis requires an in-person evaluation, based on your photos I do feel that you need lateral osteotomies to close and narrow the roof of your nasal vault. Other maneuvers including tip refinement would likely also be helpful at the time of revision rhinoplasty. My assessment based on the photos alone is as follows:
RADIX. The area just above and below the nasion or "break point" the upper bridge of...
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+2
What Needs Done During Revision Rhinoplasty?
Both approaches may be right. :the osteotomies will result in a narrower nose while the added graft will close the open roof and possibly give the optical impression of a narrower nose.
Erel Laufer, M.D.
Tampa Plastic Surgeon
Tampa Plastic Surgeon
+1
Options for revision rhinoplasty
The good news is, you have options! The most important question is, "what are your goals?" To just treat the tip? To make the dorsum smoother? More narrow? How aggressive do you want the next procedure to be?
The least invasive option would be a non-surgical rhinoplasty which may treat the dorsum and tip, improving the contour and symmetry of the nose. This is a great option for treating open roof deformities in under 5 minutes.
Osteotomies are...
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+1
Open revision rhinoplasty
The approach depends on your surgeon's preference. There are pros and cons to both osteotomies and onlay grafts
+1
Revision rhinoplasty to correct open roof
I agree that you do appear to have an open roof deformity that would be helped with osteotomies. The tip asymmetries/bossa can also be addressed at the same time.
I would do a case like your using an open approach. Other surgeons may use an endonasal approach depending on their preferences.
Discuss your options with a few surgeons experienced in more complex revision cases and assess their before and after results in other patients. Inquire about how long after surgery the...
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+1
Revision rhinoplasty would require osteotomies to repair an "open roof" deformity
Revision rhinoplasty would require osteotomies to repair an "open roof" deformity. With regard to imprving the symmetry and appearance of your nasal tip as well as possible deviation of the columella (suggested by your photos), an endonasal (closed) or open (external) approach are both reasonable depending on the experience and preference of your surgeon.
Stephen Weber, M.D., Ph.D., Facial Plastic Surgeon
+1
Depends on what you want
Nothing "needs" to be done == It all depends on what bothers you. It is important to discuss with an experienced rhinoplastic surgeon what you don't like about y our nose and then formulate a plan. From what I see, the open roof and dorsal deformity can be corrected and a tip revision would be in order. Open or closed depends on the experience and preference of the surgeon.
+1
Revisionary rhinoplasty to treat open roof deformity
I agree that it appears you have a open roof deformity and I believe you will need lateral osteotomies to close the open roof and recreate a pleasing "A" shape to the bridge of your nose. At the same time a tip rhinoplasty could be performed to improve the symmetry of the tip and make it less bulbous. One could consider cartilage grafts depending upon your exam. These procedures could be done with or without an external incision (open rhinoplasty)...
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+1
Revision rhinoplasty
From the photos it looks like you have an open roof, and irregularities. The tip is asymmetric and the worm's eye view shows significant asymmetry and perhaps a septal deflection. From your photos( and of course a full exam would be necessary to be absolutely sure) it appears that osteotomies would be necessary. It looks like you need some grafting as well .
+1
Revision Rhinoplasty
I assume that you are the same patient that just submitted the same question without pictures. I feel you definitely need to have osteotomies and correction of the inverted V deformity. You will also need spreader grafts to improve nasal function. Extensive tip revision is necessary. Find an experienced revision rhinoplasty surgeon.
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