Description

Surgery: Revision Joseph Rhinoplasty, Septoplasty, Nasal Valve Repair, Turbinate Reduction and outfracture, Right SEG, Right Spreader, Right medial crural overlay, bilateral lateral crural strut grafts and repositioning, crushed cartilage tip and supratip graft.

Indications: Patient presents in consultation for nasal obstruction. Obstruction is bilateral (L>R) . Patient has had a previous rhinoplasty. The patient denies prior nasal trauma. Patient’s symptoms are refractory to maximum medical management with over the counter nasal steroid sprays and oral antihistamines. She notices changes in her nose with axis deviation and narrowed nostril opening on the left side. She is bothered by a hanging columella, axis deviation and midvault depression.

Description of procedure: Pre-operative diagnosis:
1. Aesthetic nasal concerns
2. Nasal valve collapse
3. Deviated septum
4. Inferior turbinate hypertrophy

Post-operative diagnosis:
1. Aesthetic nasal concerns
2. Nasal valve collapse
3. Deviated septum
4. Inferior turbinate hypertrophy

Procedure:
1. Revision open septorhinoplasty
2. Costal cartilage grafting
3. Nasal valve repair with Septal extension graft
4. Septoplasty
5. Bilateral submucosal inferior turbinate reduction
6. Bilateral inferior turbinate outfracture