wasperformed FacialSurgery.com
Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.

Revision Rhinoplasty

In this chapter I will give you a glimpse into the challenges faced by a surgeon performing a revision rhinoplasty.  This chapter will be less dry and technical than the others.  I shall pelt you with some of my philosophy on the difficulty of this operation and rant about the dangers of selecting a plastic surgeon at random to operate on your nose.  The patients whose noses you will see had unsatisfactory rhinoplasty surgery elsewhere, and I was trying to correct the problems that resulted.

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Let's start by taking another peek at normal nasal tip anatomy.  The pictures above show normal lower lateral cartilages (green) at the beginning of a first-time rhinoplasty.  They are strong, smooth, regular, intact, easy to see.  Now look at the picture below.  We find no recognizable cartilage structure at the beginning of the operation.  What is left of her lower lateral cartilages is encased in a mass of scar tissue.

Click on any image in this tutorial to see a greatly-enlarged version
Every nose responds to surgery by making a layer of scar tissue underneath the skin, but with proper technique the scar tissue doesn't interfere with the appearance of the nose and doesn't stand in the way of achieving the desired results.

Above we see slightly different views of the same patients: normal on the left, abnormal on the right.

(Use the page links, immediately below this paragraph, to navigate through the pages of this chapter.)

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Clear all red checks in the Rhinoplasty Tutorial

All surgery depicted in this essay, except where noted, was performed by Dr. Denenberg