Areas where revision occurs frequently and correction-oriented applications:
In rhinoplasty surgeries, some of the cartilages (lateral alar cartilages) in this area are usually removed to reduce the tip of the nose, if the removed amount is too much, the tip part of the nose cannot bear the weight of the tip of the nose over time and creates a flattened appearance in the nose wings as if it is compressed with a latch. We describe this deformity as “pinch nose”.
Therefore, both aesthetic problems occur and the air flow entering the nose decreases as the opening of the nose wings decreases and breathing problems begin. You can see that you breathe more easily when you pull your nose wings sideways with your finger (cottle test).
In Revision Rhinoplasty, if there is not enough cartilage in the nose, these cartilages are obtained primarily from behind the ear. Another important problem that may occur in the tip area is the problems related to the low, high or large nose tip. A low nasal tip is a problem that we often see, patients usually say that they are satisfied with the result of the first surgery, but that the tip of the nose has dropped over time. There could be many reasons for this.
Curvature of the Nose, Problems with Nasal Discharge
There may be right, left “C” shaped or “S” shaped curvature on both sides of the nose.
The reason for these curvatures may be bone, cartilage alone, or both. Curvatures in the bone may be due to incomplete fracture in the first operation, insufficient (wet fracture) or fracture at the wrong level, and post-operative trauma to the nose. In curved noses, the nose always tends to turn towards the area where it was previously curved after surgery.
The nasal bone should be broken again using the method we call lateral osteotomy and brought to the midline. In curvatures in the cartilage, these curved cartilages should be supported again with cartilages (spreader graft) to support them.
Drops, Collapses and Irregularities in the Nasal Bridge
As a result of the excessive removal of the arched part on the nasal bridge, some problems may be observed over time.
The most serious of these is the inward collapses on the nasal bridge (saddle nose), this is a serious and difficult problem to correct. Slight collapses can be corrected by placing cartilage grafts in this part.
However, in severe collapses, cartilages taken from the ear or rib are prepared and used. These cartilages are sometimes supported with fascias to increase their effectiveness.