PREOPERATIVE DIAGNOSIS: Nasal obstruction to internal valve collapse, weak left external valve (weak rim), turbinate hypertrophy and deviated septum.
PROCEDURE: External Rhinoplasty
- Repair of nasal vestibular stenosis secondary to weak left external valve collapse secondary to left alar rim weakness with placement of left alar rim graft.
- Repair of bilateral nasal vestibular stenosis secondary to bilateral internal valve collapse secondary to narrow/subluxed upper lateral cartilages with placement of bilateral spreader grafts.
- Complex septal reconstruction, submucous resection with major partial vomerectomy for correction of deviated nasal septum.
- Submucous resection and partial resection of right inferior turbinate.
- Submucous resection and partial resection of left inferior turbinate.
- Harvest of temporalis fascia on right.
FINDINGS: Thin skin over dorsum, slightly malpositioned L > R lower lateral cartilages, septum deviated to left, left lower lateral cartilage wider than right, right greater than left middle vault narrowing, long middle vault, large dorsal hump, concave L medial lower lateral cartilage.
COMMENT: This patient wished to improve the appearance of a nasal hump and fix her breathing. Post-operative photos demonstrate a more aesthetically pleasing nose. The patient’s open airway has led to an improvement in breathing as well.