Revision Rhinoplasty Before & After: Addressed Crooked Nasal Appearance, Nostril Asymmetry, & Nasal Obstruction

Revision Rhinoplasty #31

Our beautiful patient is seen one year after complex revision rhinoplasty surgery using MTF (Musculoskeletal Tissue Foundation) rib cartilage. She had a previous rhinoplasty performed by another surgeon about a year before meeting us, during which all useful, graftable cartilage was removed from her nasal septum. The previous surgery resulted in a severely crooked nasal appearance, nostril asymmetry, and nasal obstruction. In our surgery, we deprojected the lower third of her nose and corrected the base of her nasal septum with a left septal extension graft. Her airway was supported with lateral crural strut grafts, which were also used to address her nasal tip asymmetry. Additionally, we placed a columella shoring strut graft for structural support at the nasal tip and narrowed her nostrils. We are so grateful that she has allowed us to share her photos. She now has improved nasal breathing, and her nose appears straighter and more natural, with a less "operated" look.

Revision Rhinoplasty Before & After: Repaired Hanging Columella, Deprojected Tip, & Removed Profile Bump

Revision Rhinoplasty #30

Our beautiful patient is seen one year after tertiary revision rhinoplasty surgery. This means she had two previous rhinoplasty surgeries before we operated on her. She presented with both functional and cosmetic concerns. She was unable to breathe through her nose due to external nasal valve collapse, which was associated with a deviated nasal septum and enlarged turbinates on both sides. From a cosmetic standpoint, she disliked how much her nose protruded on profile (overprojected), as well as the leftward tilt of her tip, which resulted in a crooked, operated appearance. In her postoperative photos, we can see a straight nasal profile from the front view and a deprojected nasal tip in profile, giving her a less distracting, more feminine appearance. Her repair involved bilateral lateral crural strut grafts to maintain airway patency and restore nasal tip symmetry. We also repaired her hanging columella, deprojected her tip, and removed a small profile bump. We are so grateful that she has allowed us to share her photos!

Revision Rhinoplasty Before & After: Tip Deprojection and Tip Rotation

Revision Rhinoplasty #29

Our beautiful 30-year-old patient presented to our office with functional and cosmetic concerns after previous rhinoplasty surgery. She was dissatisfied with the appearance of her profile because her nose was persistently long and her tip was overprojected. Additionally, she had significant droopiness of her nasal tip both on profile and front view with smiling.

From a functional standpoint, she had difficulty breathing through her nose because she had both internal and external nasal valvular collapse. The goals of her surgery were to downsize the appearance of her nose with tip deprojection and tip rotation. Her functional nasal airway collapse was corrected with bilateral, lateral crural extension grafts, and bilateral spreader grafts, and correction of her severely deviated nasal septum. Her photos were taken one year after her revision rhinoplasty in our practice. Not only is there a more feminine and less distracting nasal appearance, additionally, she breathes much better. We are so grateful that she allowed us to post her photos.

Patient Review:

“Dr. Joseph did an amazing job with my revision rhinoplasty! I was so unhappy for years after my first rhinoplasty and was worried about trusting another surgeon to fix my nose. Dr. Joseph really understood exactly how I wanted my nose to look. He also fixed all the issues inside my nose that were obstructing my breathing. Overall, going with Dr. Joseph was the best decision I ever made, I wish I did it sooner!”

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Revision Rhinoplasty Before & After: With Previous Nasal Surgery

Revision Rhinoplasty #27

Our lovely patient had a history of previous nasal trauma and previous nasal surgery around 20 years before consulting with us. She did not like her tip appearance, and she felt as though her nasal profile appearance was a "ski slope". She was noted to have a wide nasal bridge appearance and visible dorsal septum. Her nasal tip was pointy and overprojected. She had nasal obstruction from over-resection of tip cartilage at her primary rhinoplasty surgery. Her photos were taken nearly one year after we performed revision rhinoplasty. We closed her "open roof deformity" with osteotomies, and camouflaged her visible dorsal septal cartilage with a septal cartilage onlay graft. Her nasal tip was deprojected and reconstructed with lateral crural extension grafts and a columellar strut graft. You can see a more pleasing and less distracting nasal appearance, and she is breathing better after her nasal valvular reconstruction.

Revision Rhinoplasty Before & After: 1 Year Post Functional and Cosmetic Revisions

Revision Rhinoplasty #26

Our lovely 25 year old patient is seen here one year after functional and cosmetic revision rhinoplasty surgery. Our patient had 100% left nasal obstruction due to a severely deviated nasal septum that was not addressed at her first surgery. She had one of the worst deviated nasal septa we have seen in over 23 years! She was also bothered by her crooked nasal appearance and droopy nasal tip appearance. You can see a straighter, more natural looking, and better breathing nose that blends in.

Patient Review:

“Dr. Joseph gave me my life back. After a failed rhinoplasty at only 17 years old I spent 7 years waiting for the right time and the right doctor to fix it all. I had a severely deviated septum and couldn't breathe out of my left nostril at all. I had multiple ENTs tell me I had nearly 100% blockage on my left side. From the front my nose appeared crooked and had a bump on one side and a very noticeable indent on the other. I hated almost every picture that was taken of me because this "v" shaped nose showed up even more in certain lighting. I knew a functional and cosmetic revision rhinoplasty was inevitable but I was traumatized from my first experience with a different doctor in New Jersey. After spending countless hours researching and having consultations with other doctors I knew Dr. Joseph was the doc for me. He knew my case was going to be difficult and shared with me that I had one of the worst deviated septums he had ever seen but he was confident he could improve my breathing and the aesthetics of my nose. I trusted him and he truly exceeded my expectations. My breathing is nearly perfect and he turned a VERY ugly nose into something beautiful and more importantly he restored my confidence. ”

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