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Chapter-33 Revision Rhinoplasty

BOOK TITLE: Sataloff's Comprehensive Textbook of Otolaryngology: Head & Neck Surgery (Facial Plastic and Reconstructive Surgery) - Volume 3

Author
1. Kridel Russell W H
2. Sturm-O’Brien Angela
ISBN
9789351524595
DOI
10.5005/jp/books/12699_34
Edition
1/e
Publishing Year
2016
Pages
14
Author Affiliations
1. University of Texas Health Science Center, Houston, Texas, USA
2. University of Texas Health Science Center, Houston, Texas, USA
Chapter keywords
revision rhinoplasty, cookbook rhinoplasty, excise subcutaneous scar tissue, inverted V deformity, septum, the internal nasal valve, dorsal hump, dorsal saddling, dorsal augmentation graft, Nasal tip bossae, domal cartilages

Abstract

This chapter discusses revision rhinoplasty, which is a complex surgery. Performing a cookbook rhinoplasty with a standard set of steps for all rhinoplasties leads to inadequate treatment of the patient. The improved visualization and maneuverability allows precise placement and fixation of grafts in the case of overresection, excellent access to the tip and the ability to excise subcutaneous scar tissue from the previous surgery. An inverted V deformity occurs when the upper lateral cartilages are not reattached to the septum leading to allowing descent over time, leading to narrowing at the internal nasal valve and nasal obstruction. A dorsal hump that is over aggressively reduced can lead to scooped or saddled appearance rather than a naturalappearing dorsum. Correction of the dorsal saddling with a dorsal augmentation graft is performed after addressing an open roof or inverted V deformity, if present. Nasal tip bossae are unilateral or bilateral protuberances of the lower lateral and domal cartilages that can be congenital, traumatic, or iatrogenic.

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