Augmentation Female Rhinoplasty
There are a small subset of patients who seek correction of deformities which require complex grafting techniques. Some of these patients may have had overly aggressive rhinoplasty (revision rhinoplasty), use of substances which may cause collapse of the nose (I.e. Cocaine, etc), or a disease process which may cause collapse of the nose (Leprosy, Wegner's granulomatosis, Syphillis, etc).
Surgeons repairing these deformities must have a comprehensive understanding of both the process which created the deformity and the technical aspects of recreating a normal appearing nose.
Many surgeons have attempted to oversimplify this problem by focusing attention only to correcting the dorsum. Unfortunately, results will often look unsatisfactory to both patient and outside observer. Alternative solutions to creating a nasal dorsum include costal cartilage, alloplatic implants, and cancellous bone. Dr. Shah will only utilize costal cartilage for many reasons.
Some surgeons overaugment the nasal dorsum when attempting to recreate the nasal dorsum. An overly high radix, particularly in a female, can lead to improvement but may not provide the aesthetic satisfaction desired by the patient. Photoimaging plays a critical role in determining the look the patient is seeking, along with what the surgeon believes he can create.
Along with the nasal dorsum, many of these patients have a complete loss of the nasal septum. This means that there is little support to the nasal tip and that the tip will droop down and the nostrils will flair out. Reconstruction of the nasal septum with costal cartilage is a key component of recreating the tip support and nasal structure missing in the nose.
Case Example: Example of a patient with complete collapse of nose as a result of leprosy. Patient was treated with a variety of medications by an outside physician to ensure that the leprosy was in remission (not active).
Patient exhibits complete collapse of nasal dorsum with the nasal tip support nearly nonexistent. She also has flair to her nasal base.
During surgery, two ribs were taken to help reconstruct her nose. This patient required extensive nasal grafting in order to completely reconstruct her nose.
Patient seven months after reconstruction of her nose. She demonstrates an improved dorsal profile and better nasal tip definition. Her alar base flair was reduced without the need for alar base reduction.
More patient photographs can be seen in Dr.Shah's office.
- Anil Shah, MD, FACS
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- United States, IL, Chicago, 200 West Superior St., Suite 200, 60654
- (312) 944-0117
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