Challenging revision rhinoplasty case of a young female patient with thick nasal skin who had undergone 3 prior nasal surgeries. She was noted to have an upturned and overly rotated tip, wide and bulbous tip appearance, and deviated nose. Intra-operative findings included the prior placement of cadaveric rib cartilage as a dorsal implant and artificial dermal substitute previously placed on the tip. Revision rhinoplasty techniques included the use of rib cartilage, replacement and fixation of dorsal implant, lateral crural strut grafts and composite ear graft. Very challenging revision case given the thick nasal skin and the previous use of dermal substitute on the tip as well as the multiple prior procedures. Tip refinement is limited by the thicker skin coverage and scarring from the dermal substitute and prior procedures. The nose now appears with a greater degree of tip refinement and tip counter-rotation as well as a straightening of the dorsum.
- Anthony Bared, M.D., F.A.C.S.
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- United States, FL, Miami, 6280 Sunset Dr #506, 33143
- (305) 666-1774
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