Revision Rhinoplasty | Case 225
Our female patient had undergone rhinoplasty many years ago in Ottawa. Unfortunately she had hit her nose against a car door and subsequently noticed her nasal breathing was reduced. She disliked the pointy tip, felt her nose was too large and didn’t want such a curved profile.
This degree of curvature to the bridge was typical of rhinoplasty a generation ago. Most surgeons now agree with the adage ‘Resect and regret, preserve and conserve’. The overly sharp tip is a result of her thin skin and the surgeon’s choice of cutting her tip cartilages so they became very angled. Also at the time of surgery, her septum was found to be aggressively resected leaving too little to maintain the strength of her nose. This accounts for her symptoms arising from such a minor nasal injury as bumping her nose against a car door.
The results are a clear improvement. She now has a normal appearing nose. It is smaller by four millimeters, a moderate reduction in overall size, and allowed her tip to fall back towards her face and reduce the scope of her profile.
Revision rhinoplasty unfortunately can never obtain the same degree of improvement possible as primary rhinoplasty. The scarring, loss of tissue planes and resection of cartilage and bone all contribute to this fact. Before and after rhinoplasty photos of a Toronto patient of Dr Oakley Smith, expert in rhinoplasty surgery.