Rhinoplasty - Medical Before & After Case 192

Rhinoplasty is generally considered one of the most difficult procedures by plastic surgeons for a variety of reasons. The nose not only affects the appearance of the face, but also function with breathing, smell, and taste. As a result, rhinoplasty can both positively and negatively affect the sinuses. Another difficult aspect is that the nose is a three dimensional structure that sits in the center of the face. Deviations and asymmetries are more noticieable in the nose, as compared to the eyes or cheeks. 

This gentleman wanted rhinoplasty to improve the symmetry of the nose. His nose had grown significantly asymmetric without prior injury or trauma. He had already undergone a septoplasty by another surgeon, but still had persistant severe nasal asymmetry and congestion. He was referred to facial plastic surgeon Dr. Chaboki to review revision rhinoplasty options. Examination revealed bony and cartilaginous irregularity on the bridge and an unstable tip. In addition, the nasal passages were still blocked from the severe deviated septum.

Despite prior rhinoplasty and the complexity of the surgery, he underwent a closed rhinoplasty, thus avoiding an external scar between the nostrils. Dr. Chaboki, who specializes in closed rhinoplasty, used the patient's own cartilage from the nasal septum to help stabilize tip and improve nasal symmetry. Osteotomies (i.e. bone reshaping) were required to adequately improve the nose.

Postoperative photographs are approximately 1.5 years after revision rhinoplasty surgery, which demonstrate the natural improvement. The improved symmetry is most noticeable on frontal, base, and top down views. Comparing with the 1 week result (frontal view), the nose continues to become more refined with time as swelling gradually resolves over several months. He's very happy with both the cosmetic and functional revision rhinoplasty results.

Patients want a balanced nose that fits the face and functions normally. Dr. Chaboki may suggest additional procedures along with the rhinoplasty, such as septoplasty, nasal valve repair, turbinate reduction, and/or endoscopic sinus surgery as appropriate to improve nasal function.