I am devastated with my septorhinoplasty results and am wondering how much can be done to improve it. I am unhappy with the obvious inverted V deformity and no cartilage/projection of my nose from front view, also the nasal bones are detached and not level and I can feel a big gap. I feel like the surgeon took too much bone off, and didn't touch the tip, making it look big and droopy, ESPECIALLY when I smile. Please let me know what can realistically be done, I am ready to commit to fixing this.
September 11, 2015
Answer: Revision rhinoplasty Well your nose did not come out well. Why is failed is difficult to answer. But you do have a "long skin sleeve" which will tell and expert to minimize dorsal reduction. I don't know if the caudal septum was trimmed enough and the tip widely undermined to allow for tip rotation.Its also hard to understand what all the depressions are. They are atypical for internal valve collapse, which you probably have.PLAN: After a year has passed from surgery, you need the dorsum raised with septal cartilage grafts, the tip undermined and rotated by trimming the caudal septum anteriorly . The redundant lower edge of the upper lateral cartilages should be trimmed, preserving the mucosa on the interior surface. Spreader grafts for the internal valves are usually not needed when you graft the dorsum. I don't know what is needed for the alar cartilages, but I would check them out. Now this plan may be modified after an examination or during surgery. I would keep the nose taped for more than a week, changing the tape if necessary, maybe using 2 silk sutures to close the anterior transfixion incision and leaving the silk in for several weeks or more, supporting the tip until the gross edema decreases.
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September 11, 2015
Answer: Revision rhinoplasty Well your nose did not come out well. Why is failed is difficult to answer. But you do have a "long skin sleeve" which will tell and expert to minimize dorsal reduction. I don't know if the caudal septum was trimmed enough and the tip widely undermined to allow for tip rotation.Its also hard to understand what all the depressions are. They are atypical for internal valve collapse, which you probably have.PLAN: After a year has passed from surgery, you need the dorsum raised with septal cartilage grafts, the tip undermined and rotated by trimming the caudal septum anteriorly . The redundant lower edge of the upper lateral cartilages should be trimmed, preserving the mucosa on the interior surface. Spreader grafts for the internal valves are usually not needed when you graft the dorsum. I don't know what is needed for the alar cartilages, but I would check them out. Now this plan may be modified after an examination or during surgery. I would keep the nose taped for more than a week, changing the tape if necessary, maybe using 2 silk sutures to close the anterior transfixion incision and leaving the silk in for several weeks or more, supporting the tip until the gross edema decreases.
Helpful
