PROCEDURE DETAILS

Patient presented for evaluation for treatment of complications arising from previous rhinoplasty. Patient had dorsal augmentation rhinoplasty with silicone implant some time ago (another surgeon) but patient started having issues with the implant. The implant became deviated, got infected and was about to come through the skin (threatened exposure). She had previously had implant exchange due to the same issue. As such, I recommended that the implant be removed and that she undergo an autologous secondary rhinoplasty. As such, patient underwent open rhinoplasty with removal of silicone implant followed by dorsal augmentation using diced rib cartilage graft and temporo-parietal fascia wrap, tip modification with ear cartilage graft and lateral osteotomy to narrow the width of the nose. In addition, patient underwent serial fat grafting to improve on skin quality as well as to improve the appearance of the nose. Patient was also able to breath better. A revision rhinoplasty is much more complex and difficult than a primary (first-time)rhinoplasty. The skin is scarred in and the tissue does not move as much. In addition, the soft tissue is harder to control. However, she achieved a good result whereby she maintained her dorsal height and improved tip projection using her own tissue.