Patient Photos

Reverse Prior Rhinoplasty And Correct Tip Pinching, Bossa and Asymmetric Nostrils

This Vancouver, British Columbia rhinoplasty patient travelled from his home country of Portugal to have Dr. Lamperti repair the problems he encountered with his nose following wo prior closed rhinoplasty procedures. The patient had undergone two prior closed rhinoplasties several years before but he was left unhappy with his overly pinched tip along with the narrowed middle third of his nose which blocked his internal nasal valves. Additionally, he also developed a tip bossa on his left dome region. Importantly, the patient also had chronic bilateral nasal blockage that didn't improve with allergy medication. During the office consultation Dr. Lamperti also noted extensive scarring involving the roof of the patient's inner nostril region which had led to vertical malpositioning of the patient's lower lateral crura. This created weak alar margins and a very pinched nasal tip appearance. Dr. Lamperti also diagnosed a severely deviated nasal septum. The patient was really interested in recreating his prior nasal tip as much as possible. Dr. Lamperti performed an open revision rhinoplasty and septoplasty to correct the patient's issues. The upper nostril scar bands were divided which allow Dr. Lamperti to repair the vertically malpositioned lower lateral cartilages. This along with alar batten grafts improved the severe supra-alar pinching that the patient had developed. Spreader grafts were placed to correct the patient's inverted-v deformity. The patient's pinched tip was evidenced by his overly-narrowed tip defining points. Dr. Lamperti found that the nasal domes were only 5 millimeters apart. This is far too narrow for a male nose such as his. Dr. Lamperti therefore widened the tip using a spacer grafting technique in which a cartilage graft was placed between the nasal domes in order to place them 8 millimeters apart. In the approximately 10 month after photos you can see already how the patient has a much more natural appearing tip with corrected pinching and bossa. On profile view you can see how his infra-tip has a more natural contour with corrected blunting. You can also appreciate the wider nasal middle third. On base view you can see how the patient's nostril asymmetry is vastly more improved following surgery. Importantly, the patient's breathing is markedly improved as well. It should be noted that the patient has some expected residual tip skin edema at this stage that should gradually improve further over the next several months.