Patient Photos

Asian Revision Rhinolasty To Treat Upturned and Pinched Tip

This patient had had several prior rhinoplasty surgeries including placement of a silicone bridge implant which was replaced due to an infection. She wasn't happy with how upturned her tip had become along with how pinched her tip appeared. She also had significant external nasal valve collapse which was causing chronic nasal obstruction. Given that her bridge and implant were not causing any issues Dr. Lamperti recommended an open revision rhinoplasty to address the patient's tip concerns. Due to the patient's age and lack of sufficient septal cartilage, cadaver rib cartilage was used for grafting. A caudal septal extension graft was carved which allowed Dr. Lamperti to counter-rotate the nasal tip cartilage downward. He also carved and placed alar batten grafts to address the external nasal valve collapse. The patient's tip definint points were measured intraoperatively and found to be only 4 mm apart, which was the cause for the nasal tip pinching. Dr. Lamperti placed a cartilage spacer graft between the nasal domes to widen this distance to a more normal 7.5 mm. To further reduce tip rotation Dr. Lamperti also placed a shield graft. In the 1 year after photos you can see how the patient's upturned tip is nicely corrected. Additionally, her pointy tip looks more natural with a smoother transition from the tip defining points to the nostril (alar) margin.