PREOPERATIVE DIAGNOSIS: Nasal obstruction secondary to residual deviated septum, and external/internal valve collapse following two rhinoplasties.
PROCEDURE:
1. Revision Septal reconstruction for correction of deviated nasal septum.
2. Repair of nasal vestibular stenosis with reconstruction of external valve collapse with placement of bilateral alar batten/rim grafts.
3. Repair of nasal vestibular stenosis with reconstruction of tip support with placement of columellar strut.
4. Repair of nasal vestibular stenosis with reconstruction of left internal valve collapse with placement of left spreader graft.
5. Graft, right ear cartilage.
Tertiary Revision Rhinoplasty, platelet gel application.
FINDINGS: Residual deviated caudal septum to left, absent lateral crura bilaterally (intermediate, dome and medial crural present), narrow left middle vault, poor tip support with deprojection.
COMMENT: The post-op photos reveal an improved nasal appearance and a better airway.
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