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Hey, this is Dr. Chase Lay. Wanted to talk to you very briefly about a few tips and techniques in revision rhinoplasty. Here we have an inverted V deformity and a pinched tip from over-aggressive cartridge removal. I fixed this with a spreader graft on the right and the left in between the septum and the upper lateral cartridges. That red one on the right was the right, this one on the left is the left-sided spreader graft, and then on top of this, because the profile had such a scooped out appearance, I still had to do a cartridge-only graft on top. There's also some sharpening or a very steep infratip break, so I had to put a shield graft or a tip graft of cartridge at the end to help the tip look a little more rounded and natural. In this case, this patient has an implant in and she has a retracted columella and a very sharp tip, so with three separate pieces of cartridge, I created a more rounded natural-looking Asian tip on her nose.
This patient has an L-shaped implant in and got a nose that was shortened. I lengthened this by adding cartridge grafting to the dorsum, as well as the columella and the tip, to give it a longer look that still fit her face as was natural. In general, you want to find a surgeon who actually has an interesting revision rhinoplasty because it does take more time, expertise and cartridge grafting from your ribs, ears, septum or donor cartridge. With all that being said, it is common for a revision rhinoplasty to cost more than a primary rhinoplasty. Your healing time will be longer than with a primary rhinoplasty, and for your final results, you're going to need to be patient, sometimes 12 months or even a year and a half before you can really say whether or not the surgery was successful. Thanks for your time. I hope this was helpful.