Patient Photos

Revision Rhinoplasty To Replace Malpositioned Dorsum Silicone Implant With Tissue Bank Rib Cartilage

This Bellevue revision rhinoplasty patient suffered a severe crushing nasal fracture many decades ago in a motor vehicle accident. The severely depressed nasal bridge fracture was repaired at the time using a silicone implant over the bridge. Ultimately the patient's silicone implant became misplaced in which it was too far toward the left and down by the tip. This resulted in a obvious asymmetry and also an unnatural pollybeak type deformity as seen on profile view. Besides this, the patient also had twisted tip cartilages and right alar rim retraction.  Dr. Lamperti used an open revision rhinoplasty technique to remove the patient's entire malpositioned silicone implant. Tissue bank rib cartilage was then carved to build up the bridge and form a new properly sized dorsal implant graft in which the depressed nasal bridge was rebuilt. Additionally, the patient's crooked tip cartilages were straightened and supported using a caudal septal extension graft and a right rim graft was also placed to correct the patient's alar retraction. The patient's left supra-alar pinching was corrected using an alar batten graft. In the 4 month postoperative  photos you can see how the patient now has a much more natural, masculine, symmetric appearing nose. The patient's excess columellar show has been improved along with the alar retraction. Most notably, the patient's profile line is smooth and straight as it transitions from the upper bridge down toward the tip.