Dr. Epstein: This is Dr. Epstein. I'm with a patient, six days status post revision rhino. A crazy case. A very pretty girl, had two prior nose surgeries. She's smiling. You can show us [inaudible]. Anyway you can see what she had done. You can see this over projected, over upwardly rotated tip. It turns out that this was created by the placement of a graft. You can see from the bottom how lopsided she was. From the frontal view, you saw how the columella hangs down. She had all these little things. Here she is six days post-op.

Female: Hi.

Dr. Epstein: You can see basically this is a really tough case. I had to use cartilage from inside the nose to downly rotate the septum.. You see now the profile. This is just a nice double break instead of what we had here, this overly upwardly rotated tip. I brought the tip down. I also built up... You see how [inaudible] there was cartilage. I used some cartilage do build up her lateral nasal region.

Lastly I built up her profile with a little bit of Gore-Tex, which is laying in really nicely. Everything looks really nice. Can you smile for me, sweetie? Good. The tip stays nice and straight. She's happy. Bottom view. One last view. It's nice and straight as opposed to what she had before. Take a look at this and see how nicely she's healing up already. Anyway here's the frontal view and that's the most important thing. She's back to being a happy... She always was, but it looks great. She's happy.

Revision Rhino Post-Op 6 Days: Tip and Bridge Build-Up,

Dr. Jeffrey Epstein presents a revision rhinoplasty patient nearly a week out of surgery. She had her tip and bridge built up as well as her right lateral region expanded to hide a frontal view asymmetry.