Revision Rhinoplasty

Revision Rhinoplasty Before & After Photos

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Revision Rhinoplasty Patient 11


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 Rhinoplasty Patient 12

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 Rhinoplasty Patient 13

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.


Revision Rhinoplasty Patient 14

This patient presented to Dr. Bhama with complaints of nasal obstruction. He underwent nasal surgery with a different surgeon in the past with partial relief of his symptoms. On preoperative pictures, noticed the narrow middle vault and the very narrow nostrils. He had substantial valve collapse during inspiration. Options were discussed, and the patient elected for revision nasal surgery. Dr. Bhama performed complex revision surgery using multiple techniques. Postoperatively, the patient was very happy with the results of his breathing. Notice the improved contour of the nose on frontal view and the more patent nostrils on base view.


Revision Rhinoplasty Patient 15


This patient presented to Dr. Bhama complaining of nasal obstruction despite previous nasal surgery with another surgeon. Options were discussed and she elected for revision nasal surgery. She did not have any cosmetic concerns that she wanted to address. She underwent complex revision septorhinoplasty with nasal valve repair. Autologous auricular cartilage was harvested from her ear for reconstruction. Post-operatively, she recovered uneventfully and was very happy with the improvement in her breathing as well as the cosmetic appearance of her nose.


Revision Rhinoplasty Patient 16


This patient underwent septoplasty with a different surgeon and developed a septal perforation (hole in the nasal septum). He was referred to Dr. Bhama for persistent difficulty breathing through his nose as well as chronic nasal drainage. On exam, he was found to have a 1 cm septal perforation and very poor tip support. He was also found to have substantial collapse of the nasal valve. Options were discussed with the patient and he elected for revision surgery. He did not desire any major cosmetic change in the appearance of his nose. Dr. Bhama performed complex revision surgery including septorhinoplasty, repair of a septal perforation using temporalis fascia interposition grafting, a caudal septal extension graft, and extended spreader grafts using the patient’s own auricular (ear) cartilage. Early postoperative photos are shown. Notice the preservation of the patient’s overall nasal aesthetic. His tip support improved dramatically and the septal perforation healed completely. He was able to breathe much better through his nose and was very happy with the results.


Revision Rhinoplasty Patient 17


This patient presented to Dr. Bhama for second opinion regarding previous rhinoplasty surgery with another surgeon. She had undergone rhinoplasty surgery several years ago at which time some an implant was placed into the nose for augmentation. Over the past several years, she had noticed intermittent swelling and pain of the nose and partial extrusion of the implant. On pre-op photos, notice the partially implant extruding through the nasal tip. Options were discussed, and the patient elected for removal of the implant without reconstruction and cosmetic refinement. Dr. Bhama performed excision of the implant via an open rhinoplasty approach. Early postoperative pictures are shown demonstrating a healed scar. The patient did not desire any scar revision and was very happy with results. Her intermittent pain and swelling completely resolved.


Revision Rhinoplasty Patient 18


This patient presented to Dr. Bhama with nasal obstruction despite previous nasal surgery with another surgeon. On exam, her tip was ptotic and she had prominent nasal valve collapse. Additionally, she had chronic sinus disease. Options were discussed, and she elected to have revision nasal surgery. Dr. Bhama performed septorhinoplasty using cadaveric costal cartilage grafting, nasal valve repair, turbinate reduction, and functional endoscopic sinus surgery. She desired a natural appearing non-operated look without major aesthetic changes. Early post-operative photos are shown. Notice the preservation of the patient’s overall nasal aesthetic with a natural appearance and subtle rotation of the nasal tip. On base view, there is improvement in nostril symmetry and internal nasal valve patency. Her nasal breathing was dramatically improved and she was very happy with aesthetic results.


Revision Rhinoplasty Patient 19


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.


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