Asian Rhinoplasty

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 removed. She wanted to restore dorsal height that was achieved with the implant. However, given her history of implant-related infection, I recommended that she undergo an secondary rhinoplasty using her own tissue (cartilage and facia). As such, patient underwent open rhinoplasty with dorsal augmentation using diced rib cartilage graft and temporo-parietal fascia wrap, tip modification with ear cartilage graft and lateral osteotomy (narrow the width 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.