• 425.316.5080

    12800 Bothell-Everett Hwy, Suite 260
    Everett, Washington 98208

Samuel Lien, M.D.
Jeffrey Scott, M.D.
James Edwards, M.D.
Prabhat Bhama, M.D.

Revision Rhinoplasty Before & After Photos

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Revision Rhinoplasty Patient 1


This patient underwent two previous cosmetic rhinoplasty surgeries with two different, very skilled surgeons. After her second surgery, she noticed some improvement but continued to have some breathing difficulty and did not like the appearance of her nasal tip. She desired a more pronounced and rotated nasal tip. She was referred to Dr. Bhama for a third, complex revision rhinoplasty. On pre-operative frontal view, notice the droopy, poorly defined nasal tip, and excessive nostril show. Additionally, the dorsum is deviated to the left side. On frontal view when smiling, the tip droops down even lower. On profile view, her tip is under projected, and under rotated (droopy). When smiling on profile view, the tip becomes more droopy. Also notice the alar retraction and excessive columellar show. On base view, notice the asymmetry of the nostrils, and the deviation of the tip to the left side. Dr. Bhama discussed management options and the patient elected for tertiary revision rhinoplasty. Dr. Bhama performed revision dual functional and cosmetic rhinoplasty using rib cartilage. Several advanced techniques were used during her surgery, including revision septoplasty, division of the depressor septi muscle, caudal septal replacement graft, tongue in groove, tip grafting, and more. Early post-operative photos are shown. On frontal view, notice the improvement in tip position and symmetry, straightening of the dorsum, and tip rotation. On profile view, notice improvement in columellar show, tip rotation and projection, and development of a supratip break. When smiling on profile view, notice that the tip does not become more ptotic. On base view, notice improvement in nostril symmetry. The patient was very happy with the cosmetic result, and also was able to breathe through her nose with much less difficulty. Her scar will continue to fade, and the swelling will continue to improve with time.


Revision Rhinoplasty Patient 2


This young man underwent previous nasal surgery with another surgeon. Despite previous surgery, he was still unable to breathe well through his nose. Dr. Bhama performed revision surgery including septorhinoplasty, costal (rib) cartilage harvest, and reshaping of the nose with nasal valve reconstruction. The patient is able to breathe much better through his nose and has an excellent, natural-looking nasal contour.


Revision Rhinoplasty Patient 3


This gentleman had a previous history of nasal trauma resulting in a severe nasal deformity. He was unable to breathe through his nose adequately, and also had difficulty using his CPAP mask because of the deformity. He had previously undergone nasal surgery with another surgeon without sufficient improvement. Dr. Bhama performed complex revision septorhinoplasty with autologous costal (rib) cartilage grafting, osteotomies, and correction of the nasal valve with septal reconstruction. Post-operatively, he was able to breathe much better. Notice the improvement in the dorsal deviation, particularly on three-quarter view. On base view, the nose assumes a more anatomic, triangular shape and is more midline. On profile view, the tip and infratip lobule assume are less droopy, facilitating breathing and improving the appearance.


Revision Rhinoplasty Patient 4


This patient underwent nasal surgery with another surgeon with some improvement in his nasal breathing, but he desired more improvement. Notice the severe nasal valve collapse pre-operatively. He did not desire cosmetic refinements. He underwent complex revision septorhinoplasty with harvest of autologous costal (rib) cartilage grafting. Several techniques including extracorporeal septoplasty, extended spreader grafts, osteotomies, and caudal septal replacement grafting were used. Subjectively, the patient reported marked improvement in his nasal breathing. Notice the substantial improvement in nasal valve patency.


Revision Rhinoplasty Patient 5


This patient underwent previous rhinoplasty many years ago with another surgeon. She presented to Dr. Bhama with a complaint of nasal obstruction. On pre-operative base view, note the severe pinching of the nostrils, restricting airflow. On profile view, she has a “scooped-out” appearance to the dorsum. On frontal view, she has flattening of the dorsum and poor separation of the dorsal and sidewall subunits of the nose. Dr. Bhama performed complex revision septorhinoplasty using the patients own rib cartilage to reconstruct the entire framework of the nose. Post-operatively, the patient has a much more pleasing nasal aesthetic and substantial improvement in nostril patency. She was very happy with results. The scar will continue to fade with time.


Revision Rhinoplasty Patient 6


This patient underwent previous rhinoplasty with another surgeon. She presented to Dr. Bhama with complains of nasal obstruction and a nasal deformity. She was concerned that her nose was curved on frontal view and that she had a bulbous tip. Additionally, she did not like the “scooped out” appearance on profile view. She found it very difficult to breathe through either nostril. In the pre-op frontal view, notice the severe concavity of the left middle vault and bulbous tip. Base view shows obvious nostril asymmetry and collapse of the nasal valve at rest. Dr. Bhama performed complex revision septorhinoplasty with autologous costal (rib) cartilage graft taken from the patient’s own rib. Several techniques were used to reconstruct the nose, including spreader grafting, columellar strut, lateral crural struts, and more. Post-operatively, she was very happy with the result both cosmetically and functionally. Her breathing improved substantially. On frontal view, notice the improvement in the dorsal lines and improved tip definition. On profile view, her dorsum is straight. Base view demonstrates excellent improvement in nasal valve support and nostril symmetry. These pictures demonstrate an early result – swelling will continue to decrease with time.


Revision Rhinoplasty Patient 7


This patient was referred to Dr. Bhama for nasal obstruction. She underwent nasal surgery many years ago for difficulty breathing with inadequate relief of her symptoms. She did not want any major cosmetic changes to her nose. Pre-operative photos demonstrate pinching of the middle vault on frontal view. On pre-operative profile view, notice the acute nasolabial angle and sharp, droopy nasal tip. She desired improvement in her nasal airway and a natural, non-operated look. Dr. Bhama performed complex revision septorhinoplasty with autologous costal (rib cartilage) graft from the patients own chest. Several techniques were used for reconstruction. Post-operatively, notice the improvement in her tip rotation and dorsal lines on frontal view. On profile view, improvement in tip rotation is also obvious. She wishes to retain her dorsal profile, which has been preserved. She was able to breathe much better through her nose post-operatively and was very pleased with the cosmetic appearance of her nose.


Revision Rhinoplasty Patient 8


This patient presented to Dr. Bhama and complained of difficulty breathing through her nose despite use of nasal sprays. She had also undergone previous nasal surgery by a different surgeon. On pre-operative photos, notice the acute nasolabial angle on profile view, the prominent supra-tip break, and the severe asymmetry of the nostrils on base view. Options were discussed, and she elected for functional septorhinoplasty. Dr. Bhama performed revision septorhinoplasty and performed complex septal reconstruction using the patient’s ear cartilage. On post-operative photos, notice the softening of the supra-tip break, and substantial improvement in nostril symmetry and patency of the L nostril. She was very happy with the result and was able to breathe through her nose much better.



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    Plastic, Hand, and Reconstructive Surgery

    12800 Bothell-Everett Hwy
    Suite 260
    Everett, WA 98208

    425.316.5080

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