Revision Nasal Surgery/Rhinoplasty

Revision Nasal Surgery/Rhinoplasty Before & After Photos

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Revision Nasal Surgery/Rhinoplasty Patient 1


This patient presented to Dr. Bhama with a chief complaint of nasal obstruction. She had previously undergone septal surgery with another surgeon. She also desired straightening of the nasal dorsum and a natural, “non-done” appearance. On preoperative frontal view, noticed the deviation of the dorsum to the right and the thinning of the middle vault. Dr. Bhama discussed options and she elected for septorhinoplasty. Postoperative photos are shown. Noticed the dramatic improvement on frontal view. Her dorsum is straighter and more refined. On profile view, she has retained her preoperative anesthetic but the dorsal hump has been refined and fits her face more appropriately. Her swelling will continue to improve with time. The patient was very happy with the cosmetic results as well as the breathing.


Revision Nasal Surgery/Rhinoplasty Patient 2


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 Nasal Surgery/Rhinoplasty Patient 3


This patient presented to Dr. Bhama with nasal obstruction in the setting of sleep apnea. He has a history of unilateral cleft lip and an associated cleft lip nasal deformity. He had undergone previous surgery for his cleft many years ago. On preoperative photos, noticed the hanging columella on profile view. Base view demonstrates flattening of the nasal dorsum and asymmetry of the nasal tip. Frontal view demonstrates poor tip and dorsal projection as well as asymmetry of the nostrils. Options were discussed and the patient elected for complex cleft lip septorhinoplasty repair using a chondral cutaneous flap from his cleft lip scar and lower lateral cartilages. Rib cartilage was also used for reconstructive purposes. Early postoperative photos are shown. Noticed a dramatic improvement in his to projection and symmetry as well as his dorsal projection. On frontal view, his dorsum appears narrower and the nostrils are more symmetric. On base view, the tip has achieved a more triangular shape. He was very happy with results and noted that his nasal breathing had improved dramatically after the procedure. His swelling will continue to improve with time.


Revision Nasal Surgery/Rhinoplasty Patient 4


This patient presented to Dr. Bhama with a history of nasal obstruction. He underwent nasal surgery previously with another surgeon but continued to have difficulty breathing through his nose. Options were discussed and he elected for revision nasal surgery including septorhinoplasty and auricular cartilage grafting. On preoperative photos, noticed the poor tip support and poor tip projection. Dr. Bhama performed septorhinoplasty, nasal valve repair, inferior turbinate reduction and used auricular cartilage graft for reconstructive purposes. Early postoperative photos are shown demonstrating a substantial improvement in the triangularity of the nasal base. Also notice the improvement in tip projection. The patient was very happy with the results from both a cosmetic and breathing standpoint.


Revision Nasal Surgery/Rhinoplasty Patient 5


This patient underwent previous nasal surgery with a different surgeon and continued to have difficulty breathing through his nose. He presented to Dr. Bhama to discuss management options, and ultimately elected for revision nasal surgery including rhinoplasty, septoplasty, turbinate reduction, nasal valve repair, and costal (rib) cartilage graft. On pre-operative photos, notice the ptosis of the nasal tip, and saddle nose deformity. Surgery went well and post-operative photos are shown. Notice the improved dorsal contour and projection. He was very happy with results from both a cosmetic and breathing standpoint.


Revision Nasal Surgery/Rhinoplasty Patient 6


This patient presented to Dr. Bhama with complaints of nasal obstruction. He underwent nasal surgery with a different surgeon many years ago, and had persistent symptoms despite surgery. On exam, he was found to have a septal perforation (hole in the septum) as well. Options were discussed and he elected for revision surgery. On pre-op photos, notice the crooked nasal dorsum on frontal view. On profile view, the nose has an irregular dorsal contour. On base view, notice the collapse of the external nasal valve (nostrils) and nostril asymmetry. Dr. Bhama performed complex revision septorhinoplasty using temporalis fascia grafts, auricular cartilage grafts, as well as costal cartilage. Post-operatively, the patient was very happy with results from both a breathing and cosmetic standpoint. His septal perforation healed completely. On post-op photos, notice the improved straight contour evident on both frontal and profile views. Base view demonstrates improved nostril symmetry.


Revision Nasal Surgery/Rhinoplasty Patient 7


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 Nasal Surgery/Rhinoplasty Patient 8


This patient presented to Dr. Bhama complaining of difficulty breathing through her nose. She had previously undergone rhinoplasty surgery with another surgeon many years ago. On pre-operative frontal view, notice the twisting of the nasal tip to the patient’s right side. There is also flattening of the dorsum evident on both frontal and profile views. Base view demonstrates obvious deviation of the tip to the right and nostril asymmetry. Options were discussed and the patient elected for revision surgery. Dr. Bhama performed revision rhinoplasty and septoplasty along with turbinate reduction. Dr. Bhama used auricular cartilage grafts taken from the patient’s own ear to reconstruct the nose. Various techniques were used including extended spreader grafts, caudal septal extension grafting, suture techniques, perichondrial radix graft, and crushed cartilage grafts. Early post-operative photos are shown. On frontal view, there has been substantial improvement to the symmetry of the tip, and improved projection of the dorsum. Profile views demonstrate obvious improvement in radix projection as well as dorsal (bridge) projection. The tip has also been de-rotated. She was very happy with both cosmetic and functional results and noticed marked improvement in her nasal breathing.


Revision Nasal Surgery/Rhinoplasty Patient 9


This patient presented to Dr. Bhama with a chief complaint of nasal obstruction. He had previously undergone nasal surgery with another surgery. He also desired straightening of the nose cosmetically. Options were discussed and he elected to proceed with revision nasal surgery. On pre-operative photos, notice the crooked dorsum and asymmetric nasal tip. The patient also has a subtle dorsal hump. Dr. Bhama performed septorhinoplasty using auricular cartilage grafting from the patient’s ear, as well as multiple techniques including lateral and medial osteotomies and spreader grafting. Early post-operative photos are shown demonstrating straightening of the dorsum, an improved profile, and a symmetric tip. He was very pleased with the cosmetic appearance of his nose and able to breathe through the nose much better after surgery.


Revision Nasal Surgery/Rhinoplasty Patient 10


This patient has a history of Mohs surgery resulting in a large defect of the left nasal ala which was repaired by Dr. Bhama using an interpolated cheek flap. Her original Post-Mohs photos are shown demonstrating the defect as well. She was very happy with results and also desired rhinoplasty for chronic nasal obstruction issues. On preoperative photos, noticed the slight fullness in the left supra alar region, and a concavity of the right side of the nose. Additionally, notice the dorsal hump on profile view. Dr. Bhama performed septorhinoplasty, which went well. Early postoperative photos are shown demonstrating an improvement in the supra alar fullness on the left side as well as improvement in the concavity on the right. On profile view, noticed the improvement in the dorsal hump. She was very happy with results of surgery from anesthetic and a functional standpoint and was able to breathe much better afterwards. Her swelling will continue to improve with time.


Photo Disclaimer: Before & After photographs shown on this site are actual patients who have given permission to have their photos published. They are for illustrative purposes only. Individual results vary. Reputable surgeons do not guarantee outcomes and no prediction of outcome is implied. Individual healing characteristics and unexpected complications can affect the outcome of any surgery.

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