Revision Nasal Surgery/Rhinoplasty

Revision Nasal Surgery/Rhinoplasty Before & After Photos

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Revision Nasal Surgery/Rhinoplasty Patient 11


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 Nasal Surgery/RhinoplastyPatient 12


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 Nasal Surgery/Rhinoplasty Patient 13


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 Nasal Surgery/Rhinoplasty Patient 14


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 Nasal Surgery/Rhinoplasty Patient 15


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 Nasal Surgery/RhinoplastyPatient 16


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.


Revision Nasal Surgery/Rhinoplasty Patient 17


This patient presented to Dr. Bhama with nasal obstruction despite previous nasal surgery. She did not wish to have any major changes to the appearance of her nose. Dr. Bhama performed complex revision surgery which entailed revision septoplasty and rhinoplasty using the patient’s own auricular (ear) cartilage as grafting material. Post-operatively, notice the preservation of the patient’s overall aesthetic appearance. She was very happy with the appearance of her nose. She was able to breathe much better through her nose as well.


Revision Nasal Surgery/Rhinoplasty Patient 18


This patient was referred to Dr. Bhama for nasal obstruction. She had previous trauma to her nose and underwent nasal surgery previously with a different surgeon. She continued to have severe difficulty breathing through her nose, and had a saddle nose deformity. On pre-operative photos, notice the deviation of the nose to the right side, most obvious on base viewThis restricts airflow through the nostrils, primarily on the left side. Dr. Bhama performed complex revision surgery using auricular (ear) cartilage grafting. The patient did not wish to have a major change to her overall nasal aesthetic. Septorhinoplasty with osteotomies were performed, and numerous grafting and suture techniques were utilized. Post-operative photos are shown, demonstrating a substantial improvement in tip symmetry and nostril symmetry, most obvious on base view. Her overall appearance has improved, but she has retained a natural look to the nose. She was very happy with the cosmetic and breathing results.


Revision Nasal Surgery/Rhinoplasty Patient 19

This patient was referred to Dr. Bhama for nasal obstruction. He underwent nasal and sinus surgery with a different surgeon many years ago with improvement in his nasal breathing, but continued to have difficulty breathing through his nose. He also suffered from sleep apnea, and desired a more patent nasal airway to facilitate use of his CPAP mask. Dr. Bhama performed complex revision nasal surgery. Costal cartilage was used to reconstruct the nasal airway and create stronger nasal valves. He did not desire a major change to the appearance of his nose. Early post-operative photos are shown, demonstrating improvement in the frontal appearance of the nose as well as preservation of the overall nasal aesthetic. He noticed a substantial improvement in his breathing and was very happy with results of surgery.


Revision Nasal Surgery/Rhinoplasty Patient 20

This patient presented to Dr. Bhama with a chief complaint of nasal obstruction for many years. She broke her nose as a child and underwent rhinoplasty which only partially improved her symptoms. On her preoperative photography, notice the deviated nasal dorsum and cleft of the columella on the frontal view. On profile views noticed the attenuated columellar show and the oval prominent nasal tip. Her base view demonstrates obvious asymmetry. Options were discussed and she opted for revision surgery with Dr. Bhama. Dr. Bhama performed complex revision septorhinoplasty surgery using multiple methods including autologous auricular (ear) cartilage grafting. Caudal septal extension graft, bilateral extended spreader grafts, and dorsal onlay grafting was performed. Cephalic trim and dome narrowing sutures were also placed. Postoperatively, the patient was very happy with the results. On frontal view noticing improved dorsal contour as well as the improvement in the cleft of the columella. Profile view demonstrates a much more anatomic dorsum. On base view notice improvement in the symmetry of the nostrils and triangular shape of the nose.


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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