i'm considering revision rhinoplasty to derotate my tip. i've heard derotation is a very difficult procedure. according to my PS, my tip will be derotated by removing septocollumellar sutures placed during the original rhinoplasty. is this still considered a major procedure?
Removing Septocollumellar Sutures - Major or Minor Procedure?
Doctor Answers (3)
Counterrotation of the tip during revision rhinoplasty
Counter-rotating the tip is certainly far more difficult than rotating it, but it is a common procedure for revision rhinoplasty specialists. Removing the septocollumellar sutures may or may not provide counter-rotation, and is unlikely to provide you with significant counter-rotation. The simple act of removing the septocolumellar sutures would be a small procedure, but that is unlikely to be all your surgeon would be doing if you desire counterrotation.
A revision rhinoplasty that involves derotating your nasal tip is a significant procedure. Removing those septocollumellar sutures is one thing, but to effect the nasal tip derotation, a significant dissection must be done, not only to expose those sutures, but also to release the tissues and previous scar tissue to allow for the change of shape. To maintain the new tip shape and position might require new internal sutures, as well as cartilage grafting. An "open rhinoplasty" approach is usually used in this type of procedure. Make sure your plastic surgeon is comfortable with the techniques involved in revision rhinoplasty.
Removing Septocolumellar Sutures
Pictures would help us answer your question. Removal of septocolumellar sutures is not difficult but adjustments in you profile may be necessary after the tip is derotated.