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Female patient had undergone a previous and revison rhinoplasty from another surgeon. Her main complaints are an over-narrowed dorsum/bridge, over-projected and bulbous tip.
Procedure: Tertiary Revision Septorhinoplasty with Ear Cartilage Grafting.
Intraoperative Findings: Over-resected lower lateral cartilage with minimal to no tip support, tip graft encased with scar, caudal septum deviated to left, bony septum deviated to left, dorsal depressions over bony region, and caudal septum shortening.
Corrective Steps: Open Septoplasty to straigten deviated septum, harvest cartilage and use of caudal septal extension graft to lengthen infra-tip lobule. Conchal (ear) cartilage used for reconstruction of nasal tip with bilateral lateral crural strut grafts and shield graft (to derotate the infra-tip lobule). Crushed onlay grafts over bony dorsum to symmetrize nasal dorsum.
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